ArticleCardiovascular journal of Africa
Facilitators, context of and barriers to acute coronary syndrome care at Kenyatta National Hospital, Nairobi, Kenya: a qualitative analysis.
Article in Cardiovascular journal of Africa. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers to the Implementation of Acute Coronary Syndrome Guidelines in Healthcare: A Systematic Review.Reviews in cardiovascular medicine · 2026Pooled it
- Using evidence briefs to support future implementation planning: the case of early fibrinolysis for myocardial infarction and rehabilitation for the amputee patient in Colombia.Health research policy and systems · 2026Article
- Patient and provider perspectives on barriers to myocardial infarction care among persons with human immunodeficiency virus in Tanzania: A qualitative study.International journal of STD & AIDS · 2024Article
- Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention.Annals of global health · 2024Article
- Barriers to accessibility of medicines for hyperlipidemia in low- and middle-income countries.PLOS global public health · 2024Article
- Suboptimal Knowledge and Care of Patients with Acute Coronary Syndrome Among Nurses Working in Selected Hospitals in Addis Ababa, Ethiopia 2021.Vascular health and risk management · 2023Article
- Incidence of Acute Myocardial Infarction in Northern Tanzania: A Modeling Approach Within a Prospective Observational Study.Journal of the American Heart Association · 2021Observational
- Systematic review on epidemiology, interventions and management of noncommunicable diseases in acute and emergency care settings in Kenya.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2021Review
- Effect of a Triage-Based Screening Protocol on Diagnosis and Treatment of Acute Coronary Syndrome in a Tanzanian Emergency Department: A Prospective Pre-Post Study.Journal of the American Heart Association · 2020Article
- Acute myocardial infarction under-diagnosis and mortality in a Tanzanian emergency department: A prospective observational study.American heart journal · 2020Observational
- Provider-perceived barriers to diagnosis and treatment of acute coronary syndrome in Tanzania: a qualitative study.International health · 2020Article
- Patterns of Emergency Care for Possible Acute Coronary Syndrome Among Patients with Chest Pain or Shortness of Breath at a Tanzanian Referral Hospital.Global heart · 2020Observational
- Heart catheterization in adults in a sub-Saharan tertiary centre: 8 years' experience.Cardiovascular diagnosis and therapy · 2019Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe prevalence of ischaemic heart disease and its acute manifestation, acute coronary syndrome (ACS), is growing throughout sub-Saharan Africa, including Kenya. To address this increasing problem, we sought to understand the facilitators, context of and barriers to ACS care at Kenyatta National Hospital, with the aim of improving the quality of care of ACS.
methodsWe conducted in-depth interviews with healthcare providers involved in the management of ACS patients from January to February 2017 at Kenyatta National Hospital in Nairobi, Kenya. We selected an initial sample of key participants for interviewing and used a snowballing technique to identify additional participants until we achieved saturation. After transcription of audio recordings of the interviews, two authors conducted data coding and analysis using a framework approach.
resultsWe conducted 16 interviews with healthcare providers. Major themes included the need to improve the diagnostic and therapeutic capabilities of the hospital, including increasing the number of ECG machines and access to thrombolytics. Participants highlighted an overall wide availability of other guideline-directed medical therapies, including antiplatelets, beta-blockers, statins, anticoagulants and ACE inhibitors. All participants also stated the need for and openness to accepting future interventions for improvement of quality of care, including checklists and audits to improve ACS care at Kenyatta National Hospital.
conclusionMajor barriers to ACS care at Kenyatta National Hospital include inadequate diagnostic and therapeutic capabilities, lack of hospital-wide ACS guidelines, undertraining of healthcare providers and delayed presentation of patients seeking care. We also identified potential targets, including checklists and audits for future improvements in quality of care from the perspective of healthcare providers.
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