Predictors of Access To Sexual And Reproductive Health Services By Urban Refugees In Kampala City, Uganda
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
The influx of over 1.3 million refugees in Uganda, with over 10% settling in the capital city
Kampala, challenges the ability of urban refugees to access Sexual and Reproductive Health services
(SRH) and family planning (FP) amidst the multiple uncertainties of a precarious everyday life. Utilization
of SRH services remains low among urban refugees despite the fact that these services are essential to
those of reproductive age and vulnerable to unwanted pregnancies and its consequences and contracting
sexually transmitted infections (STIs) including HIV. Mildmay Uganda conducted a multimethod outreach
program to establish the predictors of access to SRH services by urban refugees in Kampala city. This
paper reports on social demographic characteristics that influenced the uptake of SRH services by urban
refugees.
Methods: A participatory, gender based, community-led, empowerment approach known as Gender Action
Learning Systems (GALS) was employed to deliver SRH including family planning services to urban
refugees in Kampala between March 2018 and September 2019. Urban refugees enrolled in GALS were
interviewed at the beginning and end of the GALS intervention, where both qualitative and quantitative
data were collected. Univariate, bivariate, and multivariate analyses were conducted to determine social
demographic factors influencing the uptake of SRH services by urban refugees.
Results: The study enrolled 867 participants, with 605 remaining to the end. Median age was 29 (IQR:22-
36) years with a standard deviation of 10.7, 52% of the participants had never married. Retention in the
study of the sexually active age cohort of primary interest (15 -34) was higher than the 35-54 cohort for
both men and women. There were significant associations between SRH use and age, religion and
education level among the urban refugees. Pentecostal religion (Adjusted OR 7.9; 3.5-18) and education
level of primary (Adjusted OR 3.4; 1.1-11) were associated with uptake of SRH and FP.
Conclusion: The participatory, peer-led community approach to delivering SRH services to urban refugees
in this research project boosted uptake by the refugees and supported its successful completion and
ability to address previously unknown predictors. A continuous awareness campaign using tested models
such as GALS to promote services to refugees is needed to successfully integrate newcomers into
Uganda’s general healthcare services.
Description
Keywords
Refugees, Women of reproductive age, Gender action Learning, Sexual and reproductive health
Citation
Christopher, M. S., Nakubulwa, S., Nyirabega, E., Mugabe, P., Odiit, M., Snelgrove-Clarke, E., ... & Mukasa, B. (2021). Predictors of Access To Sexual And Reproductive Health Services By Urban Refugees In Kampala City, Uganda. https://doi.org/10.21203/rs.3.rs-783459/v1