Skip to main content

Table 2 Summary of the results

From: Experiences of mothers and significant others in accessing comprehensive healthcare in the first 1000 days of life post-conception during COVID-19 in rural Uganda

Quotes

Categories

Subthemes

Themes

It was not easy to move, but I had to go to the local council to look for a letter, the process was not difficult, but again I had to look for transport; meanwhile, the baby’s condition was worsening, the temperature was high, the baby was vomiting, and it had diarrhea. (Edward)

Issues related to transport

  

I took care of my daughter, and it was not easy, we had no transport, and they never allowed motorcyclists to carry passengers, they only carried luggage (Norah)

I delivered from home because there was no transport, and the motorcyclists refused to take me to the hospital (Kaudah)

I started labouring during the daytime; unfortunately, we could not access permission to move easily, and transport to the hospital was not readily available. (Margaret)

Missed Health care Opportunities

Access to Health Services

Increasing barriers to healthcare

My wife was supposed to go back to the hospital for review but due to the situation of restricted movement, she did not go until I got permission to move from the Local Council leader. (James)

My child was sickly and needed constant healthcare. I missed most of the appointments because of the process of getting travel documents and a lack of money. (George)

I am worried about my baby, I delivered from home, yet I was supposed to deliver from the hospital, he did not get the syrup that prevents HIV in the baby. (Kaudah)

I thought about so many things and then I left everything to God. I knew the baby had to come out. I got prepared to deliver my daughter. Indeed, she pushed the baby to the floor; after delivering, this girl bled almost to death. (Norah)

Access to skilled healthcare providers

I feel the government could have come up with a solution to this problem, we needed a concrete plan to ensure that care is provided during this difficult time. You see someone should have followed up to see how we were suffering accessing care. (George)

I remained at home during the time of labour […] It was my mother who said that I can deliver from home… (Kaudah)

I reached them early in the morning one day at the health facility with my wife, but I left this place late in the evening. The nurses came late, and they left early, I had to wait for the evening nurses. (Sam)

I have not told you this, but during the COVID-19 pandemic, these children (grandchildren) fell sick [and] I had to go to the drug shop to buy drugs; this to me was very unusual, I have always taken these children to the hospital. The drugs never worked their sickness worsened and I almost lost one. (Jude)

Sickness

Distressing situations

My wife was supposed to go back to the hospital for review but due to the situation of restricted movement, she did not go until I got permission to move from the Local Council leader. (James)

Missed health care services

My child was sickly and needed constant healthcare. I missed most of the appointments because of the process of getting travel documents and a lack of money. (George)

I feel the government could have come up with a solution to this problem, we needed a concrete plan to ensure that care is provided during this difficult time. You see someone should have followed up to see how we were suffering accessing care. (George)

This time I almost died. There were so many delays…I think they [healthcare workers] are all competent, but none of them came near me, yet I had issues that I wanted to tell the midwife without any other person hearing… (Justine)

After the very sick child was examined and treated, they told me to go back home which I felt was not right. They gave me 1 month to come back for review. I realised that the health workers ended the clinics prematurely to allow them time to go home early. (George)

Communication between health caregivers and the mothers

The health workers were not welcoming at all, they kept on telling us to move away, saying that we might infect them with COVID. Indeed, the health workers were harsh on us, and I felt like not going back to the clinic because the love and care I used to receive from the health workers were no longer evident. (Rose)

The baby remained weak, and we (the husband and his wife) were supposed to go back to the hospital after a week, but I never wanted to go through the same experience again. (Edward)

Previous experiences

My wife has been seen by the nurses at the health center III I am not sure whether the treatment they offer is appropriate (Mike)

Trust

But again, another fear that I have at the main hospital they are very strict with people wearing masks. Could it be that there are many people with COVID-19 viruses at this health facility? Here in these facilities around us, it is not a must…It was so scary that at one point had to buy drugs instead of going to the hospital in fear of contracting the coronavirus. (Mike)

Maintaining the Standard Operating Procedures (SOPs)

Living in fear

These health workers distanced themselves from us. I once had something to tell them, but I could not tell them because I sat very far from the health worker who attended to me, she never even examined me. She asked me questions when everyone was hearing. I just told her that I had a headache, yet I had another issue. They gave me treatment without examining me. (Joan)

I have a feeling that this daughter-in-law might contract COVID-19 from the health facilities and bring it here because she keeps on telling me that she is going to the health facility […] Can we wait until COVID has subsided then we take the children for immunisation? (Jude)

Stress and uncertainty Fear of contracting COVID 19

I have a feeling that this daughter-in-law might contract COVID-19 from the health facilities and bring it here because she keeps on telling me that she is going to the health facility […] Can we wait until COVID has subsided then we take the children for immunisation? (Jude)

I prefer the main hospital Mbale. The only fear I had at that time was that if police found you on the road without a permission letter to move, that would be a crime, and you would risk being beaten up. (Mike)

Alternative sources of service provision and seeking care from lower health facilities

Making forced choices

My dear friend, this time I had to tell her to go to the health centre near here. I know it is not as good as the other one but due to the challenges in transport and obtaining permission to move she had to go to the nearby health facility. But I think they did a good job; I have not had any complaints from her. (Judi)

But when I reached the health facility gate, I was chased away because I did not have a mask. The gatekeepers told me to go and wear a mask. (George) VI

Lack of information at the health facility gate

Navigating the gatekeepers

The other thing I think about is when you go to the hospital for immunisation without a mask, they do not attend to you. They chase you with the baby. The first time I took the baby to the hospital, I had to come back home without the baby being seen. So, I had to go back the following day. (Norah)

Law enforcement without alternative support

The time I took my child for immunisation, they sympathised with me, and they (the guards) gave me a mask otherwise they were not going to treat my child. (Alice)

Maintaining the restrictive measures

I did not have money to buy a mask, so I sat at the health facility with my sick child whose condition was worsening each minute that passed until someone gave me a mask and I entered the hospital. (George)

Diminishing resources

Coping with increased poverty

They requested me to go and look for some drugs that were not available at the clinic, I borrowed the money, and I bought the drug. (Rose)

I had no money; I had no employment, which is why my sister died. We could not transport her to the hospital to deliver in time. (James)

Financial Implications

I saw my wife suffer from hunger because I had no money to buy food. We had no money, and the feeding was not the best. (Sam)

…I did not have money to take care of my sick child, and I could not give my child the food he was meant to eat…This was so hurting, my child’s health deteriorated during this time, and I was lucky that my child did not die. (George)

…at least I had food I sold all my goats and chicken to support my family during the difficult time of COVID, I thank God I succeeded. (Mike)