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

PAULUS-MOKGACHANE, Thato M.M.
VISAGIE, Surona J.
MJI, Gubele
September 2019

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Background: People with spinal cord injury (SCI) often have great need for healthcare services, but they report access challenges. Primary care access to people with SCI has not been explored in Botswana.

 

Objective: This study aimed to identify barriers and facilitators that users with spinal cord injuries experience in accessing primary care services in the greater Gaborone area, Botswana.

 

Methods: A quantitative, cross-sectional, observational study was conducted. Data were collected with a structured questionnaire from 57 participants with traumatic and non-traumatic SCI. Descriptive and inferential analysis was performed.

 

Results: The male to female ratio was 2.8:1. The mean age of participants was 40 years (standard deviation 9.59). Road traffic crashes caused 85% of the injuries. Most participants visited primary care facilities between 2 and 10 times in the 6 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 satisfaction with services. 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 and adequate. Availability, acceptability and accessibility aspects created barriers.

 

 

African Journal of Disability, Vol 8, 2019

Disability in national strategic plans on HIV and AIDS : a review on the national response to the interrelations of disability and HIV in eastern and southern Africa|Final report

GRANT, Kitty
STRODE, Ann
HANNASS-HANCOCK, Jill
December 2009

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This report examines national AIDS and HIV strategic plans (NSPs) in eastern and southern Africa and includes findings, discussions and best practice examples on the integration of disability throughout the countries. "Generally, the findings of the report show that less than 50% of the countries in Eastern and Southern Africa recognise disability as an issue of concern, or specifically recognise the vulnerability of people with disabilities to HIV and AIDS within their NSPs. Furthermore, it found that even where countries have recognised disability as an issue, there is limited specific guidance within the NSP on HIV-related service provision to meet the needs of people with disabilities. Only one country, South Africa, showed extensive integration of disability into the various focus areas of its NSP." The report concludes with recommendations and provides detailed appendices of national reports for each country surveyed

HIV/AIDS communication in selected African countries : interventions, reponses and possibilities

PARKER, Warren
RAU, Asta
PEPPA, Penny
2007

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This review looks at communication activities around HIV prevention in 11 countires in South and East Africa operating in 2006 at a national level. It considers the variations in HIV epidemiology between countries, and the heterogeneity within them, and examines the different approaches to communication that are used. The country summaries include a synopsis of the epidemiology, indicators of knowledge, behaviour and service uptake and information about HIV and AIDS prevention communication, activities, approaches and funding

Providing antiretroviral treatment in southern Africa : a literature review

HEALTH SYSTEMS TRUST
February 2004

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This report outlines experience with ART in a number of sub-Saharan countries. ART is provided through a number of different avenues, which include the public sector, the non-profit sector, the corporate sector and the private sector. ART programmes may involve collaboration between two or more sectors with such partnerships being encouraged in recognition that the magnitude of the task may exceed the capacity of any one sector. Particular attention is paid to Botswana, the first sub-Saharan country to provide ART on a wide-scale through the public sector. The report consists of four chapters, focusing on provision of ART in the different sectors, challenges to scaling up ART programmes (including community preparedness and involvement of people living with HIV/AIDS, and issues for further research

Breaking the cycle : ensuring equitable access to HIV treatment for women and girls

FLEISCHMAN, Janet
February 2004

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Outlines the situation of women and girls with regard to vulnerability to HIV and access to treatment. Makes recommendations for US policy reflecting the links between abuses against women and girls, and HIV/AIDS. Describes treatment programmes in Botswana and South Africa, and work around community mobilization and the involvement of civil society in ensuring access to ARV treatment

The development, implementation and evaluation of interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe : a literature review of evidence-based interventions for home-based child-centred development

STREBEL, Anna
2004

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This short paper gives a literature review of many programmes aimed at supporting orphans and vulnerable groups in the southern Africa region. It is not an in-depth survey, but provides a compact and accessible guide to the many different community initiatives that have been undertaken. It finishes with a short section on the lessons to be learned from care programmes

A description of the selected interventions for the care of orphans and vulnerable children in Botswana, South Africa and Zimbabwe

DLAMINI, Phetsile K
2004

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This report contributes to phase one of a research programme which explores the social, political, economic and systemic determinants that affect vulnerability to HIV. This report documents existing interventions to gain more in-depth knowledge of interventions at grassroots level, identify their strengths and weaknesses, and consider opportunities and threats; analyse and assess the outcomes of such interventions and whether objectives were met, including the impact on vulnerable children, their families and communities, considering nutritional and education status, and psychosocial well-being; ascertain the level of awareness around HIV and AIDS, and especially of prevention strategies and care

Impact of AIDS on early childhood care and education

HEYMANN, Joey
June 2003

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This policy briefing sets out the background of the HIV pandemic and notes thats its impact has transformed childhood. Findings from a study in Botswana assessing the impact show results in areas of childcare, caring for sick children and parental time with children. Policy recommendations are made concerning the implications for the quality, quantity and nature of early childhood care and education services needed, and also for the supports that are necessary to enable parents and extended family members to care for children who are affected and infected by HIV

Collaboration with traditional healers in HIV/AIDS prevention and care in sub-Saharan Africa : a literature review

KING, Rachel
September 2000

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This report gives an update on AIDS and traditional medicine in Africa. It continues to discuss the integration and collaboration of traditional medicine with national health care systems. Eight intervention projects in the resource-constrained settings of sub-Saharan Africa are selected from all interventions involving traditional healers and then compared

Social marketing for adolescent sexual health : results of operations research projects in Botswana, Cameroon, Guinea and South Africa

ASHFORD, Lori
2000

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AIDS, other sexually transmitted infections, and unintended pregnancies have reached critical levels in sub-Saharan Africa, creating a need for innovative prevention programs for vulnerable groups. This report describes operations research projects in Botswana, Cameroon, Guinea, and South Africa that attempted to determine whether social marketing interventions improved adolescent understanding of sexual health issues and access to reproductive health products and services

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