Approximately 70.8 million individuals are displaced worldwide and of these 25.9 million are
refugees (UNHCR, 2019). According to UNHCR (2018), 85% of the world’s refugees are
hosted by low-income nations such as Uganda. Presently, the country faces Africa’s highest
refugee crisis in years (ibid). The scale of the problem is growing rapidly, with refugee numbers
increasing from half a million in 2016 to 1.36 million in 2019 making it the third-highest
refugee-hosting country in the world (ibid). Most of the refugees in the country are women and
children (IRC, 2014). While the country recently shot to prominence with regards to refugee
settlement and management, it is confronted with the subsequent protection and assistance
demands (Mwenyango and Palattiyil, 2019).
Refugees have the right to the highest attainable standard of health. Health, however, is
influenced by individual behaviour, social-cultural factors and other social determinants
including the migration process and status (WHO, 2018). The conditions experienced before,
during transit and in host destinations create and increase vulnerability for poor health
outcomes (ibid). Women and children on the move are exceptionally vulnerable to inequities
that operate through exploitation and abuse (Freedman, 2019; Alsaba and Kapilashrami, 2016;
IOM, 2014; Papadopoulos; 2008; Berends, 2017).
Social work is a distinct profession that alleviates suffering and deprivation of individuals and
groups, due to its professional values of respect for human rights, social justice and care (IFSW,
2012). This study sought to examine the health needs and services for refugee women and
children in the Nakivale refugee settlement (NRS) Uganda and enunciated the role of social
work in responding to such needs. I specifically examined: (a) the public health needs,
vulnerabilities and experiences of refugee women and children (b) accessible health services
and (c) barriers to accessing and utilising health services for this group. All three were united
by the overarching goal of interrogating social work’s role in health promotion. The study used
mixed methods (quantitative and qualitative). I administered a survey of 377 refugee women
and 69 in-depth interviews (refugee women and men and key informants). The findings
indicate that the Government of Uganda and its partners in refugee work are trying to support
refugees to overcome the devastating conditions. However, there are outstanding gaps/ barriers
(individual, socio-cultural and structural) to access and utilisation of health services. Women
and children continue to live in vulnerable conditions. The study reveals a necessity for social
work in settlements and provides recommendations for improving health services. The need to
improve refugees’ access to health care is urgent because it impacts their worth and dignity and
is essential for the country’s development (UNDP, 2016)
