Factors Affecting Access to Healthcare Systems for Children under Five Years with Disability in Low Resource Setting: A Case Study of Wajir County Referral Hospital, Kenya

Abstract:

Background: Children with disabilities face inequalities in accessing healthcare systems, particularly in low-resource settings. The situation is particularly dire in Kenya, where disability is still widely viewed as a curse or a punishment, and where many traditional healers claim to have the ability to cure disabilities. As a result, many children with disabilities in Kenya frequently have unmet special healthcare needs. Understanding the challenges faced by differently-abled children under five years old in accessing healthcare in low-resource settings is crucial to developing more responsive and effective healthcare systems for this population. Methods: In this hospital-based cross-sectional study, we aimed to investigate the factors affecting access to healthcare for disabled children under five years old in Wajir County, Kenya. We used a simple random sampling technique to recruit 69 caregivers of disabled children, who were interviewed using an interviewer-administered questionnaire. Ethical approval was granted by the KNH/UON Ethical Committee. We used descriptive and inferential statistics, including chi-square tests, to analyze the data using SPSS version 25.0. Results: The majority of the caregivers were women (75.4%). We found that several factors were significantly associated with healthcare accessibility, including the belief that disability was caused by demon possession (p=0.019), reliance on traditional healers for the treatment of disabilities (p=0.034), accessibility of healthcare facilities (p=0.034), distance to the health facility (p=0.042), perceived differential treatment of disabled children (p=0.047), medical costs (p=0.028), lack of access to physiotherapist services (p=0.008), and difficulty in getting appointments suitable for the child (p=0.015). Conclusion: Our findings suggest that children with disabilities in Wajir County face significant barriers in accessing healthcare services, which are compounded by socio-cultural beliefs and economic challenges. A more coordinated, collaborative, and multidisciplinary approach is needed to improve healthcare access for this vulnerable population. Policymakers, healthcare providers, and caregivers should work together to address the identified barriers and ensure that disabled children under five years old have access to the healthcare services they need to thrive.