Access to health care, reproductive health and disability: A large scale survey in Sierra Leone

  • Social Science and Medicine, Volume 73, No. 10, Year 2011

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Study Justification:
– This study aimed to compare the health status and access to health care services between disabled and non-disabled individuals in urban and peri-urban areas of Sierra Leone.
– The study specifically focused on access to reproductive health care services and maternal health care for disabled women.
– The study aimed to identify any disparities in access to health care services based on disability status and socioeconomic characteristics.
– The study aimed to highlight the importance of addressing these disparities and promoting equal access to health care for all individuals, regardless of disability status.
Study Highlights:
– People with severe disabilities had less access to public health care services compared to non-disabled individuals, even after adjusting for socioeconomic characteristics.
– There were no significant differences in the use of contraception between disabled and non-disabled individuals.
– Contrary to expectations, disabled women were as likely as non-disabled women to report access to maternal health care services.
– Socioeconomic inequality, rather than disability, was found to be the primary factor governing access to reproductive health care services.
– Disabled women were found to be sexually active and in need of access to reproductive health services.
– Disparity in access to government-supported health care facilities was identified as a major and persistent health inequity between disabled and non-disabled individuals in Sierra Leone.
Recommendations:
– Further strengthening of Sierra Leone’s health care system is necessary to ensure equal access to health care services for disabled individuals.
– Assessing the quality of services received by pregnant women is an important priority for future research, given the high morbidity and mortality rates in Sierra Leone.
Key Role Players:
– Sierra Leone Ministry of Health
– Non-governmental organizations (NGOs) working in the field of disability and health care
– Disabled persons’ organizations (DPOs)
– Health care providers and professionals
– Community leaders and advocates for disability rights
Cost Items for Planning Recommendations:
– Funding for infrastructure development and improvement of health care facilities
– Training programs for health care providers to enhance their knowledge and skills in providing inclusive care for disabled individuals
– Awareness campaigns and education programs to promote equal access to health care services
– Research funding for assessing the quality of services received by pregnant women
– Budget allocation for monitoring and evaluation of the implementation of recommendations

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This is the first study to compare health status and access to health care services between disabled and non-disabled men and women in urban and peri-urban areas of Sierra Leone. It pays particular attention to access to reproductive health care services and maternal health care for disabled women. A cross-sectional study was conducted in 2009 in 5 districts of Sierra Leone, randomly selecting 17 clusters for a total sample of 425 households. All adults who were identified as being disabled, as well as a control group of randomly selected non-disabled adults, were interviewed about health and reproductive health. As expected, we showed that people with severe disabilities had less access to public health care services than non-disabled people after adjustment for other socioeconomic characteristics (bivariate modelling). However, there were no significant differences in reporting use of contraception between disabled and non-disabled people; contrary to expectations, women with disabilities were as likely to report access to maternal health care services as did non-disabled women. Rather than disability, it is socioeconomic inequality that governs access to such services. We also found that disabled women were as likely as non-disabled women to report having children and to desiring another child: they are not only sexually active, but also need access to reproductive health services. We conclude that disparity in access to government-supported health care facilities constitutes a major and persisting health inequity between persons with and without disabilities in Sierra Leone. Ensuring equal access will require further strengthening of the country’s health care system. Furthermore, because the morbidity and mortality rates of pregnant women are persistently high in Sierra Leone, assessing the quality of services received is an important priority for future research. © 2011 Elsevier Ltd.

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The study titled “Access to health care, reproductive health and disability: A large scale survey in Sierra Leone” provides valuable insights into the challenges faced by disabled individuals in accessing healthcare services, particularly in the context of reproductive health and maternal care. The study highlights the importance of addressing socioeconomic inequalities as a key factor in improving access to healthcare services for all individuals, including those with disabilities.

The findings of the study indicate that people with severe disabilities in Sierra Leone have less access to public healthcare services compared to non-disabled individuals, even after considering other socioeconomic factors. However, there were no significant differences in the use of contraception between disabled and non-disabled individuals. Surprisingly, disabled women reported similar access to maternal healthcare services as non-disabled women.

The study emphasizes that it is socioeconomic inequality, rather than disability itself, that plays a significant role in determining access to reproductive health and maternal care services. This highlights the need to address disparities in access to government-supported healthcare facilities as a crucial step in achieving health equity for all individuals, including those with disabilities.

The study concludes that improving access to healthcare services for disabled individuals in Sierra Leone requires strengthening the country’s healthcare system. Additionally, given the persistently high morbidity and mortality rates among pregnant women in Sierra Leone, it is essential to assess the quality of services provided in order to address this issue effectively.

Overall, the study underscores the importance of addressing socioeconomic inequalities and strengthening healthcare infrastructure to improve access to maternal health services and reproductive healthcare for all individuals in Sierra Leone, including those with disabilities.
AI Innovations Description
Based on the information provided, the recommendation to improve access to maternal health in Sierra Leone is to strengthen the country’s healthcare system and address socioeconomic inequalities. This can be achieved through the following steps:

1. Enhance healthcare infrastructure: Invest in improving healthcare facilities, particularly in rural and peri-urban areas where access to maternal health services may be limited. This includes ensuring the availability of well-equipped clinics and hospitals with skilled healthcare professionals.

2. Increase healthcare funding: Allocate sufficient resources to the healthcare sector, specifically targeting maternal health services. This can help in expanding the reach of healthcare facilities, improving the quality of care, and reducing financial barriers for women seeking maternal healthcare.

3. Improve transportation and logistics: Enhance transportation networks and systems to facilitate the timely and safe transportation of pregnant women to healthcare facilities. This can involve providing ambulances or other means of transportation in remote areas, as well as establishing referral systems to ensure seamless access to higher-level healthcare facilities when needed.

4. Address socioeconomic inequalities: Implement measures to reduce disparities in access to maternal health services based on socioeconomic factors. This may involve targeted interventions such as providing financial assistance or subsidies for healthcare services to economically disadvantaged women, as well as addressing cultural and social barriers that may prevent certain groups from accessing healthcare.

5. Increase awareness and education: Conduct comprehensive awareness campaigns to educate women and communities about the importance of maternal health and the available services. This can help in dispelling myths and misconceptions, promoting early antenatal care, and encouraging women to seek appropriate healthcare during pregnancy and childbirth.

By implementing these recommendations, Sierra Leone can work towards improving access to maternal health services, reducing maternal morbidity and mortality rates, and ensuring that all women, including those with disabilities, have equal opportunities for reproductive healthcare.
AI Innovations Methodology
The methodology used in the study “Access to health care, reproductive health and disability: A large scale survey in Sierra Leone” involved conducting a cross-sectional survey in 2009 in 5 districts of Sierra Leone. The study randomly selected 17 clusters, totaling 425 households, to gather data on health status and access to health care services for disabled and non-disabled men and women in urban and peri-urban areas.

The survey included interviews with all adults identified as disabled, as well as a control group of randomly selected non-disabled adults. The interviews focused on health and reproductive health, with particular attention given to access to reproductive health care services and maternal health care for disabled women.

The data collected was analyzed using bivariate modeling to compare access to public health care services between disabled and non-disabled individuals, after adjusting for other socioeconomic characteristics. The study also examined the use of contraception and access to maternal health care services among disabled and non-disabled individuals.

The findings of the study revealed that people with severe disabilities had less access to public health care services compared to non-disabled individuals, even after adjusting for socioeconomic characteristics. However, there were no significant differences in the reporting of contraception use between disabled and non-disabled individuals. Contrary to expectations, disabled women were as likely as non-disabled women to report access to maternal health care services.

The study concluded that it is socioeconomic inequality, rather than disability, that governs access to reproductive health care services in Sierra Leone. The authors emphasized the need to strengthen the country’s health care system to ensure equal access to government-supported health care facilities. They also highlighted the importance of assessing the quality of services received by pregnant women, given the persistently high morbidity and mortality rates in Sierra Leone.

This study provides valuable insights into the factors influencing access to maternal health care in Sierra Leone and highlights the need for targeted interventions to address socioeconomic inequalities and strengthen the health care system.


Statistics:
Citations: 81
Identifiers:
DOI: 10.1016/j.socscimed.2011.08.040
ISSN: 02779536
Research Areas:
Disability, Health System and Policy, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health
Study Countries:
Sierra Leone
Study Design:
Cross Sectional Study, randomised-control-trial
Study Approach:
Quantitative
Participants Gender:
Male & Female
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