Perceived Barriers to Healthcare Access Among Paediatric Patients With Haemophilia in Cambodia: A Cross-Sectional Survey.

INTRODUCTION

Haemophilia is a rare inherited bleeding disorder, and in low- and middle-income countries, care is often limited by delayed diagnosis and restricted access to specialised services. In Cambodia, care is centralised in only two treatment centres, which may further limit timely diagnosis and treatment.

AIM: To assess perceived barriers to healthcare access among paediatric patients with haemophilia in Cambodia.

METHODS

A cross-sectional survey was conducted in Cambodia from July to December 2025 among 100 reachable patients aged ≤18 years with Haemophilia A or B from a National Hemophilia Registry of 250 patients. Data were collected through telephone or face-to-face interviews using a structured questionnaire administered primarily to parents or caregivers.

RESULTS

Among 100 participants, 88% reported at least one diagnostic barrier, mainly limited caregiver knowledge, difficulty accessing experienced providers, and delayed referral. Barriers to daily home-based bleeding management were reported by 83%, largely related to inadequate caregiver education and limited healthcare support. Barriers to accessing haemophilia treatment centres affected 73%, mainly geographic distance, financial constraints and transportation difficulties. Delays in receiving treatment were reported by 69% and were significantly associated with clotting factor shortages, financial constraints and delayed referral. Clotting factor shortage was not significantly associated with home-based management barriers but contributed to treatment delays. Most participants reported satisfaction with care (82%) and perceived care as equitable (85%).

CONCLUSION

Paediatric haemophilia care in Cambodia is limited by geographic, financial, educational and health-system barriers. Improving education, referral pathways, home-care support, clotting factor supply and financial protection may strengthen care access.