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Stock-outs, uncertainty and improvisation in access to healthcare in war-torn Northern Uganda

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  • Muyinda, Herbert
  • Mugisha, James

Abstract

Stock-outs, also known as shortages or complete absence of a particular inventory, in public health facilities have become a hallmark in Uganda's health system making the notions of persistent doubt in access to healthcare – uncertainty, and doing more with less – ‘improvisation’, very pronounced. The situation becomes more critical in post-conflict areas with an over whelming burden of preexisting and conflict-related ailments amidst weak health systems. Particularly in the war-torn Northern Uganda, the intersection between the effects of violent conflict and shortage of medications is striking. There are problems getting the right type of medications to the right people at the right time, causing persistent shortages and uncertainty in access to healthcare. With reference to patients on Antiretroviral Therapy (ART), we present temporal trends in access to healthcare in the context of medication shortages in conflict-affected areas. We examine uncertainties in access to care, and how patients, medical practitioners, and the state – the key actors in the domain of supplying and utilizing medicines, respond. Our observation is that, while improvisation is a feature of biomedicine and facilitates problem solving in daily life, it is largely contextual. Given the rapidly evolving contexts and social and professional sensitivities that characterize war affected areas, there is a need for deliberate healthcare programs tailored to the unique needs of people and to the shaping of appropriate policies in post-conflict settings, which call for more North-South collaboration on equal terms.

Suggested Citation

  • Muyinda, Herbert & Mugisha, James, 2015. "Stock-outs, uncertainty and improvisation in access to healthcare in war-torn Northern Uganda," Social Science & Medicine, Elsevier, vol. 146(C), pages 316-323.
  • Handle: RePEc:eee:socmed:v:146:y:2015:i:c:p:316-323
    DOI: 10.1016/j.socscimed.2015.10.022
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    References listed on IDEAS

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    1. Okello, D. O. & Lubanga, R. & Guwatudde, D. & Sebina-Zziwa, A., 1998. "The challenge to restoring basic health care in Uganda," Social Science & Medicine, Elsevier, vol. 46(1), pages 13-21, January.
    2. AfDB AfDB, . "Annual Report 2012," Annual Report, African Development Bank, number 461.
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    1. Chebolu-Subramanian, Vijaya & Sundarraj, Rangaraja P., 2021. "Essential medicine shortages, procurement process and supplier response: A normative study across Indian states," Social Science & Medicine, Elsevier, vol. 278(C).
    2. Esther Kalule Nanfuka & David Kyaddondo & Sarah N Ssali & Narathius Asingwire, 2018. "Social capital and resilience among people living on antiretroviral therapy in resource-poor Uganda," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-21, June.
    3. James Mugisha & Herbert Muyinda & Heidi Hjelmeland & Eugene Kinyanda & Davy Vancampfort & Birthe Loa Knizek, 2018. "Cultural responses towards the aftermath of suicide among the Acholi in Northern Uganda," International Journal of Social Psychiatry, , vol. 64(6), pages 545-553, September.

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