"Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda.
Primary healthcare (PHC) systems are the first point of contact for healthcare users and are critical for disease prevention and early treatment. The COVID-19 pandemic overwhelmed PHC systems globally, including in sub-Saharan Africa, significantly impacting access to essential services. We describe...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0005046 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849228073303539712 |
|---|---|
| author | Rachel Kawuma Joseph Katongole Abdmagidu Menya Winnie Eoju Jonathan Kitonsa Katherine Gallagher Deborah Watson-Jones Eugene Ruzagira |
| author_facet | Rachel Kawuma Joseph Katongole Abdmagidu Menya Winnie Eoju Jonathan Kitonsa Katherine Gallagher Deborah Watson-Jones Eugene Ruzagira |
| author_sort | Rachel Kawuma |
| collection | DOAJ |
| description | Primary healthcare (PHC) systems are the first point of contact for healthcare users and are critical for disease prevention and early treatment. The COVID-19 pandemic overwhelmed PHC systems globally, including in sub-Saharan Africa, significantly impacting access to essential services. We describe the experiences of community PHC users' accessing and utilizing health services at 15 purposively selected health centers during the COVID-19 pandemic in Masaka district, southwestern Uganda. A qualitative study (13th-August-2021-4th-November-2021) was embedded with in a large investigation evaluating the impact of COVID-19 on PHC services across three African regions. We conducted 28 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) among adult (females and males) healthcare users (aged ≥18 years). Data was analyzed by themes and charted against the Andersen's Behavioral Model for healthcare utilization. The analysis revealed that structural adjustments to enforce COVID-19 protocols, such as handwashing stations and reduced waiting times, were viewed positively. Facilitators of healthcare access included community sensitization, positive attitudes of health workers, and users' determination despite movement restrictions. However, barriers included fear of infection, medication shortages, reduced clinic hours, and the prioritization of COVID-19 care over other services. Participants adapted by obtaining travel permission letters and using herbal remedies when conventional care was inaccessible. Our key finding is that despite significant disruptions to PHC services during the COVID-19 pandemic, healthcare users demonstrated resilience in accessing care. However, systemic challenges, such as workforce shortages and limited essential medical supplies, highlighted vulnerabilities within the PHC system. Addressing these structural barriers and investing in more resilient and adaptive healthcare systems is crucial for ensuring equitable access to essential health services during future public health crises. |
| format | Article |
| id | doaj-art-42326f1b600a43fbbd754ffd4a04976e |
| institution | Kabale University |
| issn | 2767-3375 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj-art-42326f1b600a43fbbd754ffd4a04976e2025-08-23T05:47:53ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0158e000504610.1371/journal.pgph.0005046"Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda.Rachel KawumaJoseph KatongoleAbdmagidu MenyaWinnie EojuJonathan KitonsaKatherine GallagherDeborah Watson-JonesEugene RuzagiraPrimary healthcare (PHC) systems are the first point of contact for healthcare users and are critical for disease prevention and early treatment. The COVID-19 pandemic overwhelmed PHC systems globally, including in sub-Saharan Africa, significantly impacting access to essential services. We describe the experiences of community PHC users' accessing and utilizing health services at 15 purposively selected health centers during the COVID-19 pandemic in Masaka district, southwestern Uganda. A qualitative study (13th-August-2021-4th-November-2021) was embedded with in a large investigation evaluating the impact of COVID-19 on PHC services across three African regions. We conducted 28 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) among adult (females and males) healthcare users (aged ≥18 years). Data was analyzed by themes and charted against the Andersen's Behavioral Model for healthcare utilization. The analysis revealed that structural adjustments to enforce COVID-19 protocols, such as handwashing stations and reduced waiting times, were viewed positively. Facilitators of healthcare access included community sensitization, positive attitudes of health workers, and users' determination despite movement restrictions. However, barriers included fear of infection, medication shortages, reduced clinic hours, and the prioritization of COVID-19 care over other services. Participants adapted by obtaining travel permission letters and using herbal remedies when conventional care was inaccessible. Our key finding is that despite significant disruptions to PHC services during the COVID-19 pandemic, healthcare users demonstrated resilience in accessing care. However, systemic challenges, such as workforce shortages and limited essential medical supplies, highlighted vulnerabilities within the PHC system. Addressing these structural barriers and investing in more resilient and adaptive healthcare systems is crucial for ensuring equitable access to essential health services during future public health crises.https://doi.org/10.1371/journal.pgph.0005046 |
| spellingShingle | Rachel Kawuma Joseph Katongole Abdmagidu Menya Winnie Eoju Jonathan Kitonsa Katherine Gallagher Deborah Watson-Jones Eugene Ruzagira "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda. PLOS Global Public Health |
| title | "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda. |
| title_full | "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda. |
| title_fullStr | "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda. |
| title_full_unstemmed | "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda. |
| title_short | "Resilience amidst challenges": Healthcare users' experiences of access and utilisation of primary healthcare services during the COVID-19 pandemic in southwestern Uganda. |
| title_sort | resilience amidst challenges healthcare users experiences of access and utilisation of primary healthcare services during the covid 19 pandemic in southwestern uganda |
| url | https://doi.org/10.1371/journal.pgph.0005046 |
| work_keys_str_mv | AT rachelkawuma resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT josephkatongole resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT abdmagidumenya resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT winnieeoju resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT jonathankitonsa resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT katherinegallagher resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT deborahwatsonjones resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda AT eugeneruzagira resilienceamidstchallengeshealthcareusersexperiencesofaccessandutilisationofprimaryhealthcareservicesduringthecovid19pandemicinsouthwesternuganda |