Date of Award
8-2024
Degree Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Advisor
Dr. Samuel Otido
Second Advisor
Dr. Angela Migowa
Third Advisor
Dr. Roselyter Riang’a
Department
Paediatrics and Child Health (East Africa)
Abstract
Background: Asthma is one of the most common chronic conditions in children, with significant morbidity and mortality, especially in Africa. Achieving adequate asthma control in children remains challenging due to gaps between standard recommended management strategies and treatment practices. This study explored barriers to asthma management as perceived by children and their caregivers in a private tertiary care setting in Kenya.
Methods: An exploratory phenomenological qualitative study was conducted at Aga Khan University Hospital (AKUH), Nairobi. Children aged 6–18 years with a confirmed diagnosis of asthma and their caregivers were recruited. Participants had been receiving treatment for at least one year but had partly controlled or uncontrolled asthma. Purposive sampling was used, and in-depth interviews were conducted with 14 child-caregiver pairs until data saturation. Data was analysed using NVivo software version 12.
Results: Three pre-determined themes were highlighted and explored in this study. These were barriers to medication use, barriers to treating modifiable risk factors, and barriers to non-pharmacological strategies. One emerging theme was identified: loss of trust in the health care system. Barriers to medication use were most frequently reported and included challenges with drug administration, forgetfulness, lack of support from schools and extended families, stigma, and monotony in treatment regimens. Barriers to modifiable risk factors focused on difficulties attending clinic appointments, while non-pharmacological strategy barriers included the high costs of implementing recommended adjustments and ineffective environmental control. The emerging theme was the loss of trust in the health care system, which resulted in parents avoiding consultations with general practitioners or opting for over-thecounter treatments instead.
Conclusions: Despite adequate knowledge of asthma and its management, participants faced significant challenges, including medication adherence, environmental factors, and healthcare access. Overcoming these barriers requires a comprehensive approach that engages families, schools, and the wider community.
First Page
1
Last Page
84
Recommended Citation
Ahimbisibwe, J. K.
(2024). Child and caregiver’ perspective on barriers to Asthma management at a tertiary referral hospital in Kenya. , 1-84.
Available at:
https://ecommons.aku.edu/etd_ke_mc_mm-paeds/39