OVC Support Toolkit  >  Health and nutrition  >  All Children and their Health and Nutrition 

Access to Health Care

This section looks at issues which affect the access of orphans and other vulnerable children to health care. Other sections cover general issues of health and nutrition and details of nutrition and access to food. Many of the barriers to accessing health care are the same as those which prevent children from accessing education.

Key barriers to access to health care for orphans and other vulnerable children are:

1. Lack of money
2. Distance to the health facility and availability of transport
3. Lack of time to seek health care
4. Lack of a family care giver
5. Lack of health knowledge among children and care givers
6. Negative attitudes and limited skills of some health workers
7. Lack of appropriate services at health care settings

The importance of access to health care

Ensuring access to essential services is one of the five key strategies identified in the global strategic framework introduced in 2004. Health is one of those essential services.

Barriers to services

1. Money: Lack of money is a major reason why children fail to receive the health care they need. Money is often needed to pay to see a health worker, to get medicines and for transport to the health facility. Children and their care givers may lose income if they spend time seeking health care.
2. Distance to health facilities: Distance to the health facility affects access to health care. Children and young people will need to spend more money and time on getting health care if their home is far away from the health facility. Availability of transport affects the degree to which distance is a barrier.
3. Time: Children and their care givers may lack the time they need to seek health care. This is particularly true if the child is acting as a care giver within the home. Adult care givers may have commitments to work, agriculture or the home which stop them taking a child to the health centre.
4. Care givers: There may be other reasons why a parent or other adult care giver is unable to take a child for health care. For example, they may be ill themselves and unable to do this. Children in child-headed households may have no adult to take them for health care. In some cases, adults may feel it is not worth spending time and resources on health care for children, particularly if they have HIV. Also, some adult guardians may prioritise the needs of their own children rather than others that they care for.
5. Knowledge: Care givers may lack the skills and knowledge on health issues. For example, they may not know when to take a child to a health centre. This may be a particular problem when the care giver is a grandparent or older child/young person because much health education about children is targeted at mothers.
6. Health workers: Children and their care givers may not use health services because they fear they will not be treated well by health workers. This may be because of negative attitudes among health workers. Health workers may also lack skills to deal effectively with orphans and other vulnerable children. In some cases, people with HIV are not given treatment or are given a lower standard of treatment. There may also be fears that information about health will not remain confidential or that they will have to explain frequent trips for health care.
7. Appropriate services: It is important that children and young people not only have access to health facilities but that those facilities provide appropriate and good quality services. There may be other reasons why they do not, including lack of staff and medicines.

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