Access to primary care for persons with spinal cord injuries in the greater Gaborone, Botswana

Paulus-Mokgachane, Thato Michael Moutie (2018-03)

Thesis (MHumanRehabSt)--Stellenbosch University, 2018.

Thesis

ENGLISH SUMMARY : Introduction: People with SCI often have great need for health care services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana. Aim: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone. Methods: A quantitative, cross sectional, observational study was done. Data was collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive analysis was done. Results: The male to female ratio was 2.8:1. The mean age of participants was 40 (SD 9.59). Road traffic accidents caused 85% of the injuries. Most participants visited primary care facilities between 2 to 10 times in the six months before the study. Participants were satisfied with the services (63%) and felt that facilities were clean (95%) and well maintained (73.5%). Preferential treatment, respect, short waiting times and convenient hours facilitated an acceptable and adequate service. Availability was hampered by insufficient provider knowledge on SCI as indicated by 71.9% of participants, and shortage of consumables (80.7%). Structural challenges (42.1% could not enter the facility by themselves and 56.5% could not use the bathroom) and lack of height adjustable examining couches (66.7%) impeded accessibility. Cost was incurred when participants (64.9%) utilised private health services where public services failed to address their needs. Conclusion: Primary care services were mostly affordable, acceptable and adequate. Availability and accessibility aspects created barriers.

AFRIKAANSE OPSOMMING : Agtergrond: Spinaalkoord beserings veroorsaak 'n groter behoefte aan gesondheidsdienste. Tog ondervind persone met spinaalkoord beserings probleme met toegang tot gesondheidsdienste. Toegang tot primêre sorg vir persone met Spinaalkoord beserings in Botswana is nog nie ondersoek nie. Doel: Die doel van die studie was om hindernisse en fasiliteerders te identifiseer wat persone met spinaalkoord beserings ondervind met gebruik van primêre sorg dienste in the groter Gaberone area in Botswana. Metodes: 'n Deursnit, observasie studie is gedoen. Data was by 57 deelnemers met traumatiese en nie-traumatiese spinaalkoord beserings ingesamel deur middel van `n gestruktureeerde vraelys. Beskrywende data analise was gedoen. Resultate: Die man tot vrou ratio was 2.8:1. Deelnemers se gemiddelde ouderdom was 40 (SD 9.59). Pad ongelukke het 85% van beserings veroorsaak. Deelnemers het primêre sorg fasiliteite tussen 2 en 6 maal besoek in die ses maande voor die studie. Hulle was tevrede met die diens (63%) en was van mening dat die fasiliteite skoon (95%) en goed onderhou was (73.5%). Voorkeur behandeling, respek, kort wag periodes en gerieflike ure het verder gesorg vir aanvaarbare en voldoende dienste Beskikbaarheid is negatief beinvloed deur onvoldoende kennis oor die hantering van spinaalkoord beserings aan die kant van diensverskaffers, soos aangedui deur 71.9% van deelnemers, en `n tekort aan verbruikbare produkte (80.7%). Strukturele beperkinge (42.1% kon nie op hulle eie die fasiliteite binnegaan nie en 56.5% kon nie die badkamer gerbuik nie) en `n tekort aan hoogte verstelbare ondersoek beddens (66.7%) het toeganklikheid beperk. 64.9% van deelnemers het ekstra koste aangegaan om privaat gesondheids dienste te besoek omdat staats dienste nie aan hulle behoeftes kon voldoen nie. Gevolgtrekking: Primêre sorg dienste was oor die algemeen beskostigbaar, aanvaarbaar en voldoende. Beskikbaarheid en toeganklikheid van dienste het probleme geskep.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/103605
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