Healthcare Experiences and Service Delivery Gaps for Pregnant Women Living with HIV in Kiryandongo Settlement Camp, Northern Uganda.

Abstract

Background: HIV-positive pregnant women in refugee settings face significant barriers to accessing quality maternal healthcare. In Uganda, Kiryandongo Settlement Camp, one of the largest refugee settlements, exemplifies these challenges with limited healthcare infrastructure, stigma, and socio-economic constraints affecting healthcare delivery. This study explores the healthcare experiences and service delivery gaps for HIV-positive pregnant women in the camp.

Materials and methods: An exploratory qualitative research design was employed in Kiryandongo Settlement Camp, involving purposive sampling of 30 pregnant women living with HIV, 10 healthcare providers, and 5 key informants. Data were collected through in-depth interviews and key informant interviews.

Results: The findings revealed multiple barriers to healthcare access, categorized into three sub-themes: inadequate healthcare infrastructure, long waiting times and staff shortages, and stigma and discrimination. Participants reported frustration with the lack of medical supplies, inadequate facilities, and the impact of stigma on their willingness to seek care. Healthcare providers also acknowledged these challenges, noting limited resources and strained personnel as contributing factors. The most significant finding was the pervasive impact of stigma, which not only hindered service access but also contributed to a reluctance to engage with healthcare services, further affecting ART adherence.

Conclusion: This study highlights the critical need for improvements in healthcare infrastructure, policy interventions to reduce stigma, and increased support for healthcare providers in Kiryandongo Settlement Camp. Addressing these gaps is essential for enhancing ART adherence, maternal health outcomes, and the effectiveness of PMTCT programs in refugee settings. Despite the focus on a single site, the findings have broader implications for refugee health policy and service delivery in similar contexts.