Original Research

Access to health care for children with neural tube defects: Experiences of mothers in Zambia

Micah M. Simpamba, Patricia M. Struthers, Margaret M. Mweshi
African Journal of Disability | Vol 5, No 1 | a267 | DOI: https://doi.org/10.4102/ajod.v5i1.267 | © 2016 Micah M. Simpamba, Patricia M. Struthers, Margaret M. Mweshi | This work is licensed under CC Attribution 4.0
Submitted: 26 February 2016 | Published: 02 December 2016

About the author(s)

Micah M. Simpamba, Department of Physiotherapy, University of the Western Cape, South Africa
Patricia M. Struthers, School of Public Health, University of the Western Cape, South Africa
Margaret M. Mweshi, Physiotherapy Department, University of Zambia, Zambia


Introduction: In Zambia, all children born with neural tube defects requiring surgery need to be referred to a tertiary level hospital in Lusaka, the capital city, where the specialists are based. The aim of this study was to explore the experiences of mothers accessing health care who had recently given birth to a child with a neural tube defect.
Methods and analysis: In-depth interviews were conducted with a purposively selected sample of 20 mothers at the tertiary level hospital. The interviews were audiotaped, transcribed verbatim and translated. Content analysis was used to identify codes, which were later collapsed into categories and themes.
Findings: Five themes emerged: access to health care, access to transport, access to information, concerns about family and support needs.
Discussion: Barriers to access to health care included geographical barriers and barriers linked to availability. Geographical barriers were related to distance between home and the health centre, and referral between health facilities. Barriers to availability included the lack of specialist health workers at various levels, and insufficient hospital vehicles to transport mothers and children to the tertiary level hospital. The main barrier to affordability was the cost of transport, which was alleviated by either family or government support. Acceptability of the health services was affected by a lack of information, incorrect advice, the attitude of health workers and the beliefs of the family.
Conclusion: Access to health care by mothers of children with neural tube defects in Zambia is affected by geographical accessibility, availability, affordability and acceptability. The supply-side barriers and demand-side barriers require different interventions to address them. This suggests that health policy is needed which ensures access to surgery and follow-up care.


access to health services; Zambia; neural tube defects; mothers' experiences; accessibility; availability; affordability; acceptability


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Crossref Citations

1. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis
Hannah Blencowe, Vijaya Kancherla, Sowmiya Moorthie, Matthew W. Darlison, Bernadette Modell
Annals of the New York Academy of Sciences  vol: 1414  issue: 1  first page: 31  year: 2018  
doi: 10.1111/nyas.13548