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Urban-Rural Disparities in Chronic Obstructive Pulmonary Disease Management and Access in Uganda

Robertson, NM; Nagourney, EM; Pollard, SL; Siddharthan, T; Kalyesubula, R; Surkan, PJ; Hurst, JR; ... Kirenga, BJ; + view all (2019) Urban-Rural Disparities in Chronic Obstructive Pulmonary Disease Management and Access in Uganda. Chronic Obstructive Pulmonary Diseases , 6 (1) pp. 17-28. 10.15326/jcopdf.6.1.2018.0143.

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Abstract

Introduction: Almost 90% of chronic obstructive pulmonary disease (COPD) deaths occur in low- and middle-income countries (LMICs), where there are large rural populations and access to health care for COPD is poor. The purpose of this study was to compare urban-rural provider experiences regarding systemic facilitators and barriers to COPD management and treatment access. Methods: We conducted a qualitative study using direct observations and in-depth semi-structured interviews with 16 and 10 health care providers in urban Kampala and rural Nakaseke, Uganda, respectively. We analyzed interviews by performing inductive coding using generated topical codes. Results: In both urban and rural districts, exposure to evidence-based practices for COPD diagnosis and treatment was limited. The biomedical definition of COPD is not well distinguished in rural communities and was commonly confused with asthma and other respiratory diseases. Urban and rural participants alike described low availability of medications, limited access to diagnostic tools, poor awareness of the disease, and lack of financial means for medical care as common barriers to seeking and receiving care for COPD. While there was greater access to COPD treatment in urban areas, rural populations faced more pronounced barriers in access to diagnostic equipment, following standard treatment guidelines, and training medical personnel in non-communicable disease (NCD) management and treatment. Conclusion: Our results suggest that health system challenges for the treatment of COPD may disproportionately affect rural areas in Uganda. Implementation of diagnostic and treatment guidelines and training health professionals in COPD, with a special emphasis on rural communities, will assist in addressing these barriers.

Type: Article
Title: Urban-Rural Disparities in Chronic Obstructive Pulmonary Disease Management and Access in Uganda
Location: United States
DOI: 10.15326/jcopdf.6.1.2018.0143
Publisher version: https://doi.org/10.15326/jcopdf.6.1.2018.0143
Language: English
Keywords: Uganda, Urban-rural health disparities, chronic obstructive pulmonary disease, copd, low and middle-income countries, treatment access
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10068805
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