“But they are hard work”: A qualitative study of the perceptions of healthcare workers in providing care to persons with disabilities in Uganda

Healthcare workers play a central role in providing and facilitating access to healthcare for all. However, gaps in knowledge, training, and experience in disability care can limit their ability to provide inclusive care. Exploring healthcare workers’ perceptions and experiences is crucial for informing the development of disability-inclusive healthcare services that are accessible, responsive, and equitable.

We conducted qualitative interviews with healthcare workers (n = 13) in Luuka district, Uganda, between September and November 2022. Interviews explored healthcare workers’ perceptions and experiences in providing healthcare to persons with disabilities. Participants included nurses (n = 3), midwives (n = 2), laboratory technicians (n = 2), and clinical officers (n = 6). We also conducted key informant interviews (n = 4) with representatives from Luuka district health officials (n = 2) and the Ugandan Ministry of Health (n = 2). The interviews were audio-recorded and transcribed, and then thematically analysed.

We adapted Andersen’s Behavioural Model to focus on healthcare provision. We focused on five (5) themes: (1) knowledge and perceptions of disability, (2) perceived enabling factors, (3) perceived needs and demands for inclusive care provision, (4) systemic and structural factors, and (5) quality and inclusiveness of care. Across the themes, limited knowledge of disability, poor understanding of healthcare needs, inadequate treatment of disability-related illnesses, and negative attitudes towards persons with disabilities constrained the provision of inclusive care. These challenges were compounded by the limited availability of inclusive environments and services, which restricted healthcare workers’ ability to care for people with disabilities.

There is an urgent need to invest in building the knowledge, skills, and confidence of healthcare workers to provide inclusive and respectful care for persons with disabilities. Integrating disability awareness and inclusive care into pre-service and in-service training, improving facility accessibility, and fostering supportive work environments are essential steps toward achieving inclusive health systems. By translating these insights into action, Uganda can move closer to realising its commitment to universal health coverage and the right to health for all.