Ethical challenges in the spatial distribution of health facilities and accessibility to health services: A comparative study of Kampala and Kiboga Districts.
There is growing demand for health services in Uganda due to growing population and prevalence of various diseases. Against these circumstances is limited and inequitable distribution of health facilities like health clinics, hospitals, and referrals yet they are a critical basis for accessing and attaining health services. The study was carried out in Kampala and Kiboga districts in the Buganda region. The following hypotheses were put forward; (i) Access to health facilities affects health care differentials in Uganda. (ii) Health facilities are not equitably distributed in Kampala and Kiboga districts. (iii) Patients encounter limited non-locational difficulties in trying to access health services in the health facilities. Random sampling method was used upon 60 households with a total of over 100 respondents having 50 from Kampala and 50 from Kiboga districts. Methods for data collection used included observation, interviews, questionnaire and reviewing of secondary sources of data. Four issues were addressed in this study. First, finding out the depth and extent of the distribution of health facilities in Makindye Division and Ntwetwe sub-counties. Second, identifying the social, economic, political and ethical factors that affect the distribution of health facilities such as ignorance, affordability, respect for human rights and dignity, accountability of actions and finance among others. Third, identifying the various difficulties which health care consumers encounter such as distance, congestion, and price discrimination among others. Fourth, identifying the ethical implications of poorly distributed health facilities. Fifth, finding out the mitigation of difficulties so as to promote effective and efficient delivery of health care services. For example, providing more water points, sensitizing the communities, effective planning and policy description by the government among others. Conclusions were drawn such as persons near health facilities having low mortality due to easy access to facilities, health facilities more equitably distributed in Makindye division than in Ntwetwe sub county. Consumers face many non-locational difficulties like less money, delay in treatment, from which recommendations were put forward on how to improve on the distribution of health facilities and accessibility of health care services in Kampala and Kiboga districts. Recommendations include decentralizing health facility establishment, subsidizing medical care costs, more funding of health sector, ensure accountability among others.