Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12882-020-1702-6
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dc.titleAccess to CKD Care in Rural Communities of India: a qualitative study exploring the barriers and potential facilitators
dc.contributor.authorJafar, Tazeen Hasan
dc.contributor.authorRamakrishnan, Chandrika
dc.contributor.authorJohn, Oommen
dc.contributor.authorTewari, Abha
dc.contributor.authorCobb, Benjamin
dc.contributor.authorLegido-Quigley, Helena
dc.contributor.authorSungwon, Yoon
dc.contributor.authorJha, Vivekanand
dc.date.accessioned2020-06-10T09:25:30Z
dc.date.available2020-06-10T09:25:30Z
dc.date.issued2020-01-29
dc.identifier.citationJafar, Tazeen Hasan, Ramakrishnan, Chandrika, John, Oommen, Tewari, Abha, Cobb, Benjamin, Legido-Quigley, Helena, Sungwon, Yoon, Jha, Vivekanand (2020-01-29). Access to CKD Care in Rural Communities of India: a qualitative study exploring the barriers and potential facilitators. BMC NEPHROLOGY 21 (1). ScholarBank@NUS Repository. https://doi.org/10.1186/s12882-020-1702-6
dc.identifier.issn14712369
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/169630
dc.description.abstract© 2020 The Author(s). Background: Despite the high and rising burden of chronic kidney disease (CKD) in South Asia, factors that influence access to CKD care at the community level have not been studied previously, especially in the rural areas. We conducted a mixed methods study and interviewed key stakeholders to explore the views and experiences of key stakeholders, and identify barriers and potential facilitators that influence access to CKD care at the primary care level in rural India. Methods: A total of 21 stakeholders participated in the study. We conducted 15 in-depth interviews on a purposive sample of stakeholders (CKD patients, healthcare providers and health planners) and one focus group discussion with 6 community health workers. The interviews were audio-recorded and transcribed verbatim. We employed the Lévesque's framework for access to care to base interview guides and structure the initial codes. By inductive and deductive approaches, thematic analysis was undertaken using QSR NVivo version 11. Results: The major patient-level barriers to CKD care as reported by the most patients and healthcare providers was poor knowledge and awareness of CKD. Health system-level barriers included shortages of skilled healthcare professionals and medicines, fragmented referrals pathways to the specialists at the hospitals with inadequate follow up care. Many patients and healthcare providers, when asked about areas for improving access to CKD care, reported educational initiatives to increase awareness of CKD among healthcare providers and patients, provision of CKD related supplies, and a systems-level approach to care coordination including task shifting by engaging community health workers in CKD care, as potential facilitators. Conclusions: We identified several barriers to access CKD care at the primary care level in rural India that need urgent attention. Targeted CKD screening programs and CKD specific educational initiatives may improve awareness of CKD. Additionally, primary care infrastructure needs to be strengthened for CKD care, ensuring trained staff, availability of essential diagnostics and medications, and creating efficient referral pathways for quality CKD care.
dc.language.isoen
dc.publisherBMC
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectUrology & Nephrology
dc.subjectCKD
dc.subjectBarriers
dc.subjectFacilitators
dc.subjectRural
dc.subjectQualititative research
dc.subjectIndia
dc.subjectCHRONIC KIDNEY-DISEASE
dc.subjectBLOOD-PRESSURE CONTROL
dc.subjectSTAGE RENAL-DISEASE
dc.subjectCARDIOVASCULAR RISK
dc.subjectGLYCEMIC CONTROL
dc.subjectOUTCOMES
dc.subjectINTERVENTIONS
dc.subjectGUIDELINES
dc.subjectMANAGEMENT
dc.typeArticle
dc.date.updated2020-06-04T01:57:04Z
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.doi10.1186/s12882-020-1702-6
dc.description.sourcetitleBMC NEPHROLOGY
dc.description.volume21
dc.description.issue1
dc.published.statePublished
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