BMC pediatrics · 2025
Navigating childhood asthma care in Kenya: barriers identified by children and their caregivers.
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Ahimbisibwe Joan, Riang'a Roselyter Monchari, Migowa Angela, Otido Samuel
Аннотация
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 because of gaps between standard recommended management strategies and actual 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. The 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. The data were analysed via NVivo software version 12.
RESULTS: Three predetermined themes were highlighted and explored in this study. These were barriers to medication use, barriers to treating modifiable risk factors, and barriers to nonpharmacological interventions. 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. Modifiable risk factor barriers focused on difficulties attending clinic appointments, whereas nonpharmacological intervention barriers included the high costs of implementing recommended adjustments and ineffective environmental control.
CONCLUSIONS: Despite access to specialist-led care and good caregiver knowledge, children with asthma faced barriers such as poor medication adherence, environmental triggers, limited drug access, and inadequate school support. This suggests that expert care alone is insufficient, and a broader, system-wide approach is needed to improve asthma outcomes in Africa.
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. The 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. The data were analysed via NVivo software version 12.
RESULTS: Three predetermined themes were highlighted and explored in this study. These were barriers to medication use, barriers to treating modifiable risk factors, and barriers to nonpharmacological interventions. 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. Modifiable risk factor barriers focused on difficulties attending clinic appointments, whereas nonpharmacological intervention barriers included the high costs of implementing recommended adjustments and ineffective environmental control.
CONCLUSIONS: Despite access to specialist-led care and good caregiver knowledge, children with asthma faced barriers such as poor medication adherence, environmental triggers, limited drug access, and inadequate school support. This suggests that expert care alone is insufficient, and a broader, system-wide approach is needed to improve asthma outcomes in Africa.