Co-designing a post-discharge intervention to improve mobility recovery among patients with lower limb fractures using human-centered design in greater Kampala, Uganda.

Authors

Swaibu Zziwa, Erisa Sabakaki Mwaka, Nukhba Zia, Esther Buregyeya, Olive Kobusingye, Fred Nuwaha

Published in

PloS one. Volume 21. Issue 11. Pages e0360232. Epub Nov 10, 2026.

Abstract

Lower limb fractures are a major cause of functional limitation and require coordinated post-discharge care to support recovery and prevent complications. In low- and middle-income countries, including Uganda, continuity of care after discharge is often limited by health system constraints, socioeconomic barriers, and community barriers. This study aimed to co-design a post-discharge intervention to improve recovery among patients with lower limb fractures in Greater Kampala, Uganda, using a Human-Centered Design (HCD) approach.
A qualitative exploratory study guided by the HCD participatory and iterative framework was conducted between July and December 2025. Stakeholders including healthcare providers, community health workers, patients, and caregivers participated in focus group discussions, key informant interviews, and in-depth interviews to explore their experiences, needs, and challenges related to post-discharge care. Stakeholders subsequently participated in an iterative co-design process to prioritize and refine intervention components. Data were audio-recorded, transcribed verbatim, and analyzed thematically using NVivo version 15.
Several interconnected barriers to post-discharge care were identified, including discontinuity of care after hospital discharge, inadequate discharge information, transportation challenges, community and family influences on treatment decisions, use of traditional bone setters, and health-system limitations. Through the co-design process, stakeholders proposed intervention strategies comprising structured discharge preparation, improved documentation of patient and caregiver contact information, strengthened linkages between health facilities and community health workers, community-based follow-up, and decentralized follow-up services at lower-level health facilities.
Health-system and community-level factors influenced post-discharge care among patients with lower limb fractures. The study co-designed an integrated facility-community intervention comprising structured discharge processes, strengthened community health worker linkages, and community-based follow-up. Further studies should evaluate the feasibility and effectiveness of the intervention in improving post-discharge care and recovery outcomes.

PMID:
43007998
Bibliographic data and abstract were imported from PubMed on 11 Nov 2026.

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