Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda.
Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. From the study, known health systems problems including inadequate transport, long distance to health facilities, long waiting times at facilities and poor quality of care were confirmed, but other aspects that needed to be addressed were also established. These included key gender-related determinants of maternal health, such as domestic violence, low contraceptive use and early teenage pregnancy, as well as problems of unclean water, poor sanitation and women's lack of income. Community members appreciated learning about the research findings precisely hence designing and implementing appropriate solutions to the problems identified because they could see photographs from their own local area. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders.
Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda. Electronic address: dmusoke@musph.ac.ug.
David
D
Musoke
Department of Health Policy, Planning and Management, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
Elizabeth
E
Ekirapa-Kiracho
Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
Rawlance
R
Ndejjo
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
Asha
A
George
D000293:Adolescent; D000328:Adult; D055812:Community-Based Participatory Research; D017579:Domestic Violence / Q000523:psychology; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D000068097:Maternal Health; D008427:Maternal Health Services; D010781:Photography; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D011634:Public Health / Q000379:methods; D019035:Rural Health Services; D012499:Sanitation; D014454:Uganda; D055815:Young Adult
Uganda; health systems; maternal health; multisectoral concerns; photovoice; social determinants of health; youth