Women and post-conflict health reconstruction : a case of Puranga Sub-County, Pader District, Northern Uganda

Abstract

This thesis examined how women’s needs were incorporated in post conflict health reconstruction in Puranga Sub County, Pader District, Northern Uganda. The study asked five questions: 1. What are the post-conflict health needs of women and what is the role of women in health reconstruction? 2. How do women in post-conflict communities access health services? 3. How did post-conflict-health reconstruction address women’s needs? 4. What are the perceptions of planners and leaders of women’s needs and their participation? 5. What gender issues must be considered in health reconstruction? The main argument of the thesis is that wars impact health at two levels, the level of the physical and mental well-being of the population and the destruction of infrastructure which leads to weak health services. These impact women differently and requires specific attention to address the needs of women and girls and ensure their participation in post-conflict health reconstruction. The study used a qualitative approach employing mainly focus group discussions and key informant interviews. Fieldwork was conducted in three villages (Wicere, Entebbe and Puranga Trading Centre) in Purunga Sub-County, Pader District. Nine focus group discussions were held. The research found that the approach to health reconstruction focused more on infrastructure development, which downplayed the need to ensure women’s needs are given consideration in planning and executing health reconstruction. Healthcare services are poor due to lack of adequate health facilities, lack of adequate health workforce, supplies and equipment for the population. Data analysis revealed that health planning fits within the broader district planning, involves communities and pays attention to the maternal health needs of women. However, there is no focus to ensure that facilities built provide for women’s maternal health needs, are closer to communities and while mental health services are part of the health package, findings revealed that there are not enough mental health specialists to support the mental health wellbeing of war survivors. The overall conclusion is that conflicts create a gendered impact on health care both at infrastructure and service levels. The research makes the following recommendations: post conflict health reconstruction policies and programmes adopt gender analysis to guarantee women’s concerns are identified and incorporated into health reconstruction; governments must put in place mechanisms that ensure the inclusion of gender perspectives and that women are included in decision-making for health planning at all levels of the health system; planners need to apply gender budgeting to health planning to ensure that the health needs of all categories of people are adequately resourced; and finally the government must enhance the skills of local government to manage healthcare services, and apply gender mainstreaming at all levels including health planning, service provision and health management.