ArticleBMJ open2022
What are the barriers to the diagnosis and management of chronic respiratory disease in sub-Saharan Africa? A qualitative study with healthcare workers, national and regional policy stakeholders in five countries.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Tobacco smoking in Sub-Saharan Africa: A systematic review and meta-analysis.Drug and alcohol review · 2025Pooled it
- A 5-Year Retrospective Morbidity Profile of School-Aged Children at Ho Polyclinic, Volta Region, Ghana: Skin Conditions, Malaria, and Respiratory Illnesses as Leading Causes (2018-2022).Public health challenges · 2026Article
- Pathways of health care for people living with multimorbidity in two Southern African countries.PloS one · 2026Article
- Article
- Assessing the contributions of health deficits to frailty among older people in Sub-Saharan Africa: evidence from Côte d'Ivoire.BMC public health · 2025Article
- Assessing the capacity of primary healthcare facilities and healthcare workers in managing diabetes and hypertension in Kisumu county, Kenya.BMC health services research · 2025Article
- Applying a systems thinking approach to evaluating the effectiveness of Africa's foodborne disease surveillance systems.Communications medicine · 2025Article
- An exploratory study of context and factors shaping policies for integrated management of multimorbidity in Malawi.Health research policy and systems · 2025Article
- Post-TB sequelae and care: a systematic review and synthesis of qualitative research.IJTLD open · 2025Article
- Improving Care for People with Chronic Respiratory Diseases: Taking a Policy Lens.Advances in therapy · 2025Review
- Barriers to early and effective overactive bladder management in male patients with lower urinary tract symptoms.PloS one · 2025Article
- "People here live in denial": A qualitative study of the pervasive impact of stigma on asthma diagnosis and care in Kenya and Sudan.PLOS global public health · 2025Article
- Composite dietary antioxidant index, chronic respiratory disease, and all-cause mortality: National Health and Nutrition Examination Survey, 2003-2018.European journal of nutrition · 2024Article
- Gendered gaps to tuberculosis prevention and care in Kenya: a political economy analysis study.BMJ open · 2024Article
- Respiratory symptoms after TB treatment completion: A qualitative study of patient and provider experiences in urban Blantyre, Malawi.PLOS global public health · 2024Article
- Assessment of Knowledge and Attitude of General Practitioners Regarding Autism and Associated Factors at Gondar University Hospital, Gondar, Ethiopia.Advances in medicine · 2024Article
- Survey-identified experiences of prediagnosis and diagnosis process among patients with COPD, asthma, interstitial lung disease and bronchiectasis.BMJ open respiratory research · 2023Article
- "Asthma is a very bully disease" - patient experiences of living with chronic respiratory diseases in Cape Town, South Africa.International journal for equity in health · 2023Article
- "Honestly, this problem has affected me a lot": a qualitative exploration of the lived experiences of people with chronic respiratory disease in Sudan and Tanzania.BMC public health · 2023Article
- Integrated Diagnosis in Africa's Low- and Middle-Income Countries: What Is It, What Works, and for Whom? A Realist Synthesis.International journal of integrated careArticle
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesChronic 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
designQualitative descriptive study. SETTINGS: Primary, secondary and tertiary health facilities, government agencies and civil society organisations in five sub-Saharan African countries.
participantsWe 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.
resultsWe 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.
conclusionHealth 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.
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