Peer-reviewed article

'I really feel pity for them': health workers' readiness to offer maternal health services to urban refugee adolescents in Kampala, Uganda-a qualitative study.

Nakisita O, Garimoi-Orach C, Bukenya JN, Bagonza A, Nabiwemba E et al. · 20 Jul 2025

Abstract

Introduction Uganda hosts an estimated 1.6 million refugees and 12.5% are urban refugees living in Kampala. Uganda is implementing an integrated healthcare system where both refugee and host populations use the same healthcare services. Offering adolescent and youth-friendly services can improve access and utilisation of maternal health services. We assessed the readiness of health workers in government health facilities to provide maternal health services to urban refugee adolescents in Kampala, Uganda. In this study, health-worker readiness refers to the continued knowledge training, perceptions, attitudes, practices and prior experiences that enable providers to deliver adolescent-friendly maternal services to urban refugee adolescents. Methods This was a phenomenological study conducted in August 2024 among 12 health workers from six government health centres levels III and IV that offer maternal health services within Kampala city, Uganda. Purposive sampling technique was conducted, and skilled personnel offering antenatal and delivery services were selected and interviewed using an in-depth interview guide. Interviews were audio recorded and transcribed verbatim. Thematic and content analysis was done, and findings are presented in themes and supported with typical quotes. Results The health workers felt sympathy for the adolescent urban refugees and were willing to offer services to them. They reported that peer educators and community health workers enabled them to provide the services. However, they had inadequate knowledge about adolescent-friendly services, and they faced challenges like language barrier, lack of essential drugs, supplies and equipment. They recommended training of health workers, separate space for antenatal care and delivery for adolescents and young people with translators for refugees and improvement in the availability of essential drugs, supplies and equipment. Conclusions Health workers in government lower-level facilities are willing to provide maternal health services to adolescent urban refugees. However, they face several challenges that limit their readiness to offer the services. There is an urgent need to improve the readiness of health workers to offer adolescent-friendly maternal health services to refugees.