Access to health services amongst reproductive-aged women in post-conflict settings: Evidence from Northern Uganda

Background: In Northern Uganda, a decade long civil conflict involving the Lord’s Resistance Army displaced the population and damaged health infrastructure. Following a peace deal in 2006, the Ugandan government, with international donor assistance, has invested heavily in rebuilding the health infrastructure and in developing the public health workforce.

Objective: This study estimates how investments in health infrastructure – improved service availability, accessibility and quality – affect health services utilization amongst reproductive-aged women in Northern Uganda with an emphasis on individual, household, and health supply environment factors (availability of drugs, provider qualifications, and district health support) that facilitate or hinder use.

Methods:Combining data from approximately 6,000 randomly selected households in fifteen districts covered by the USAID-funded Northern Uganda Health Integration to Enhance Services (NU-HITES) project with health facility data from a census of public facilities, multilevel probit models of the utilization of health services will be estimated. Data collection will be completed by March 2014. 

Results and Implications: Results from the statistical models will be used to determine which factors most influence the use of health services amongst this population and to better target the interventions of the NU-HITES project. It is expected that the results will show that although individual factors drive health service use, the loss of infrastructure and the exodus of health workers from the conflict make contextual factors equally important. These data support a comprehensive approach to improving access to health care amongst reproductive-aged women in post conflict settings.