Prevalence and Spatial Patterns of Major Limb Loss in the Acholi Sub-Region of Uganda

Abstract

There is a widely reported yet poorly understood preponderance of major limb loss in Northern Uganda, caused in large part by prolonged civil war. Access to rehabilitation services is extremely limited, and there is no understanding of how many people have major limb loss, nor how many have had access to medical or rehabilitative services. This research represents the first prevalence study of disability and major limb loss in the Acholi sub-region of Northern Uganda, as well as a novel evaluation of spatial patterns in cases of major limb loss. We conservatively estimate that there are c. 10,117 people with major limb loss in Acholi (c. 0.5% of the population) who require long-term rehabilitation services, as well as c. 150,512 people with other disabilities (c. 8.2% of the population). We also demonstrate that people with major limb loss are spread throughout the region (as opposed to clustered in specific locations) and are disproportionately male, older, and less well educated than the general population. This research demonstrates a clear inadequacy in both the supply and service delivery models of rehabilitation services for those with major limb loss in the study area and provides much-needed insight into the challenges that must be addressed for an effective system to be put in place.