Evidence map›Paper›PMID 34857547›Full record

ArticleBMJ open2021

Experiences of seeking healthcare across the border: lessons to inform upstream policies and system developments on cross-border health in East Africa.

Freddie Ssengooba, Doreen Tuhebwe, Steven Ssendagire, Susan Babirye, Martha Akulume, Aloysius Ssennyonjo, Arthur Rutaroh, Leon Mutesa, Mabel Nangami

Abstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Freddie SsengoobaDepartment of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda sengooba@musph.ac.ug.
Doreen TuhebweDepartment of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.ORCID 0000-0002-9464-2340
Steven SsendagireDepartment of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Susan BabiryeDepartment of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Martha AkulumeDepartment of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Aloysius SsennyonjoDepartment of Health Policy Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.ORCID 0000-0002-5790-4874
Arthur RutarohHealth Economics and Policy, African Health Economics and Policy Association, Kampala, Uganda.
Leon MutesaCollege of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Mabel NangamiDepartment of Health Policy and Management, College of Health Sciences, Moi University, Eldoret, Uasin Gishu, Kenya.

Funding

Medical Research Council MR/R02028/1
6 · The paper itself

Abstract

objectivesThis study explored the experiences of accessing care across the border in East Africa.

participantsFrom February to June 2018, a cross-sectional study using qualitative and quantitative methods was conducted among 279 household adults residing along selected national border sites of Uganda, Kenya and Rwanda and had accessed care from the opposite side of the border 5 years prior to this study.

settingAccess to HIV treatment, maternal delivery and childhood immunisation services was explored. We applied the health access framework and an appreciative inquiry approach to identify factors that enabled access to the services. MEASURES: Exploratory factor analysis and linear regression were used for quantitative data, while deductive content analysis was done for the qualitative data on respondent's experiences navigating health access barriers.

resultsThe majority of respondents (83.9%; 234/279) had accessed care from public health facilities. Nearly one-third (77/279) had sought care across the border more than a year ago and 22.9% (64/279) less than a month ago. From the linear regression, the main predictor for ease of access for healthcare were ''ease of border crossing' (regression coefficient (RegCoef) 0.381); 'services being free' (RegCoef 0.478); 'services and medicines availability' (RegCoef 0.274) and 'acceptable quality of services' (RegCoef 0.364). The key facilitators for successful navigation of access barriers were related to the presence of informal routes, speaking a similar language and the ability to pay for the services.

conclusionCommunities resident near national borders were able to cross borders to seek healthcare. There is need for a policy environment to enable East Africa invest better and realise synergies for these communities. This will advance Universal Health Coverage goals for communities along the border who represent the far fang areas of the health system with multiple barriers to healthcare access.

Indexed as

Health FacilitiesHealth Services AccessibilityAdultChildCross-Sectional StudiesHumansPolicyQualitative ResearchUgandapublic healthquality in health care

Identifiers

PMID34857547
PMCPMC8640642

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.