| dc.description.abstract | The research focuses assessing the accessibility of health services in the hard to reach areas
with focus on Bugala Island; in Kalangala District. A clear background and significance
study has been done specifically focusing on the target area by deriving literature that points
to the area of study. The legal frame work of the study where the Uganda Constitution 1995
is referred to including other ACTs of parliament which supports the research process. The
problem statement literally brings to light the need for this research; where it is derived that
Kalangala is actually a hard to reach area which brings into question how access to health is
managed through the delivery of services. There are four objectives addressed in this
research; 1) to establish whether grass-root consultations are carried out during national
budget development processes; this is mainly to assess government deliberate efforts to
prioritize service delivery and how this translates into access to health services; 2) how the
health facilities HCII and HCIII handle referral cases; this is mainly to see how health
services address real health issues which is an accessibility issue; 3) whether there are factors
affecting sufficiency of medical personnel; addressing Human Resource allocation to justify
access to health and 4) to recommend methods of improving on health service delivery in
hard to reach areas. The conceptual scope, geographical and time scope (8months research) is
emphasized. The justification of the study is mainly to look into the policy framework and
ascertain whether this can be used as a platform to influence government policy on allocation
of resources for hard to reach areas. The conceptual framework is drawn based on the
research topic with clear independent variables (e.g. budget prioritization; transport,
communication); Intervening Variables (e.g. Governance) and dependent variables (e.g. Lack
of drugs; death).
The research adopts the Descriptive Study approach where it considers both the homogeneity
and heterogeneity of the samples to be investigated on. The research uses two sampling
methods (snowball and purposeful sampling) to select 44 respondents i.e. 15men, 20 women,
5 Health In-charges, 3 Local Council Chairpersons and 1 District Health Officer. The data
collection method is through key informant interviews for all the respondents using interview
guides, questionnaires and observation as key instruments.
The research findings, the analysis and discussion has been analyzed using Ms Excel where
37 tables; figures and graphs used to further illustrate the finding. The findings in this chapter
clearly show that; the budgeting process is fully participatory at local government levels
involving local politicians like councilors and most importantly community members.
However analysis shows that the consultations are carried out but not followed through to the
implementation level; the referral system in Bugala mainly depends on Masaka Referral
hospital which is off the main island and there is no definite system in place to know whether
referral cases actually reach their destinations; there is no water ambulance to ensure that
emergency cases reach referral centres; lack of proper transportation and the expensive
nature of transport are the main constraints facing the referral system.
Most of the recommendations and conclusions are made in light of improving service
delivery through policy reform. And so the conclusion made shows that the men and women
of Bugala Island do not have access to health services mainly because they are in a hard to
reach environment. Whereas there is an indication that the government makes grass-root
consultation, the level of these consultations translating into development planning is
detached. The interpretation here is that; the failure to provide proper access to health
services in Bugala Island only mounts to violations of Human Rights where the right to
health, information, and right from discrimination are all classified as violations. | en_US |
