Analysis of the Barriers to Healthcare Access in Informal Urban Settlements; A Case study of Agatare Settlement in Nyarugenge District

Abstract

Lack of access to healthcare worsens one’s health and reduces their productivity, which results into poverty. Poor people have less access to healthcare, yet they experience severe disease burden and live in deprived areas. This study aimed at analyzing barriers to healthcare access in informal urban settlements. A qualitative research design was adopted to meet the study objectives given its suitability in identifying the nature and characteristics of the existing financial, structural and cognitive barriers to healthcare access as per the study objectives. An interview guide was used to collect data through focus group discussions and interviews with key informants who were selected purposively. Data was analyzed through deductive content analysis in line with the “Health Care Access Barriers” (HCAB) model. The study findings revealed that majority (92%) of people in the study area have medical insurance and access healthcare services in a walkable distance. However, some barriers were identified and categorized into three themes in line with the (HCAB) model; financial (affordability, low income and competing priorities), structural (irregular availability of medicine, long waiting time and insufficient equipment and healthcare personnel)and cognitive barriers (mixed use of traditional and modern medicine). Insights from the study identified insufficient availability of medicine and equipment at health centres as the major barrier to healthcare access leading to increased financial risks, poor health outcomes and less productivity. The study therefore recommends increased availability of medicine, equipment and staffing at health facilities proportional to the needs of people in informal settlements. In addition, there is need for mind-set shift towards healthy living. Further studies should be conducted to quantify the existing gap and impact of healthcare access barriers.