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ABSTRACT: Objectives
Chronic respiratory diseases (CRD) are among the top four non-communicable diseases globally. They are associated with poor health and approximately 4 million deaths every year. The rising burden of CRD in low/middle-income countries will strain already weak health systems. This study aimed to explore the perspectives of healthcare workers and other health policy stakeholders on the barriers to effective diagnosis and management of CRD in Kenya, Malawi, Sudan, Tanzania and Uganda.Study design
Qualitative descriptive study.Settings
Primary, secondary and tertiary health facilities, government agencies and civil society organisations in five sub-Saharan African countries.Participants
We purposively selected 60 national and district-level policy stakeholders, and 49 healthcare workers, based on their roles in policy decision-making or health provision, and conducted key informant interviews and in-depth interviews, respectively, between 2018 and 2019. Data were analysed through framework approach.Results
We identified intersecting vicious cycles of neglect of CRD at strategic policy and healthcare facility levels. Lack of reliable data on burden of disease, due to weak information systems and diagnostic capacity, negatively affected inclusion in policy; this, in turn, was reflected by low budgetary allocations for diagnostic equipment, training and medicines. At the healthcare facility level, inadequate budgetary allocations constrained diagnostic capacity, quality of service delivery and collection of appropriate data, compounding the lack of routine data on burden of disease.Conclusion
Health systems in the five countries are ill-equipped to respond to CRD, an issue that has been brought into sharp focus as countries plan for post-COVID-19 lung diseases. CRD are underdiagnosed, under-reported and underfunded, leading to a vicious cycle of invisibility and neglect. Appropriate diagnosis and management require health systems strengthening, particularly at the primary healthcare level.
SUBMITTER: Mulupi S
PROVIDER: S-EPMC9345041 | biostudies-literature | 2022 Jul
REPOSITORIES: biostudies-literature
Mulupi Stephen S Ayakaka Irene I Tolhurst Rachel R Kozak Nicole N Shayo Elizabeth Henry EH Abdalla Elhafiz E Osman Rashid R Egere Uzochukwu U Mpagama Stellah G SG Chinouya Martha M Chikaphupha Kingsley Rex KR ElSony Asma A Meme Helen H Oronje Rose R Ntinginya Nyanda Elias NE Obasi Angela A Taegtmeyer Miriam M
BMJ open 20220729 7
<h4>Objectives</h4>Chronic respiratory diseases (CRD) are among the top four non-communicable diseases globally. They are associated with poor health and approximately 4 million deaths every year. The rising burden of CRD in low/middle-income countries will strain already weak health systems. This study aimed to explore the perspectives of healthcare workers and other health policy stakeholders on the barriers to effective diagnosis and management of CRD in Kenya, Malawi, Sudan, Tanzania and Uga ...[more]