Abstract
Introduction:
The global prevalence of Parkinson's disease, a common neurodegenerative disorder, is rising. Most people with Parkinson's live in low- and middle-income countries, where accessing healthcare is challenging. A growing body of literature has investigated the distribution and experience of Parkinson's disease in Tanzania, yet there remains a need to understand access to healthcare for the condition in this setting. This study aims to qualitatively explore the experience of accessing healthcare for Parkinson's disease in northern Tanzania's Kilimanjaro region.
Method:
Twenty-seven semi-structured interviews were conducted with people with Parkinson's (n=12), caregivers (n=8), and healthcare professionals involved in care (n=7). People with Parkinson's and caregivers were recruited to achieve wide variation in demographic and health characteristics. Professionals varied by occupation and workplace. Direct observation of clinical settings and detailed field notes captured contextual information. Reflexive Thematic Analysis was used to analyse data inductively and identify patterns of meaning across the dataset.
Results:
Three overarching themes were defined during analysis. The Price of Parkinson's considers the economic burden Parkinson's disease levies against individuals, and its implications for healthcare access. Making Sense of Parkinson's discusses how knowledge and perceptions of the condition influence healthcare access, whilst An Underprepared System describes how a healthcare system under-equipped to manage it poses barriers to accessing healthcare.
Conclusions:
Accessing healthcare for Parkinson's disease in Kilimanjaro region is influenced by both healthcare system and patient factors and is often challenging for those affected by the condition and those involved in healthcare. This study highlights the need for the development of effective public health interventions for Parkinson's disease in this setting. A systems approach, focussing on care affordability, public awareness, specialist service capacity, management outside of the specialist setting, and research relating to novel diagnostics and therapeutics in Sub-Saharan Africa is recommended to improve healthcare access.
Comments
This poster is really…
This poster is really interesting and raises the awareness on the shift in disease patterns now that healthcare is improved in lower- income countries and people are living longer! Now requiring training for more chronic diseases too but also highlighting the improvements made so far
Thanks for taking the time…
Thanks for taking the time to read this poster! I think this work represents an exploratory first step into the current landscape of PD in Kilimanjaro region and further quantitative and policy research should guide any targeted interventions. I think it is important to acknowledge that this research alone won't benefit people with Parkinson's unless the findings are seen by those with the ability to enact public health change in the region. I also agree that we should acknowledge the improvements that have been made so far and adopt a balanced view when examining changing disease burdens to avoid an overly pessimistic interpretation of public health in low- and middle-income countries. We have included a much more detailed discussion in the final manuscript we are hoping to publish, so please keep an eye out for the paper if you would like to learn more about our findings!
Interesting
This is really interesting. If misdiagnosis is a common theme, would there be scope for movement disorders education within the local medical schools in Moshi? This could try to make a more sustainable service in the area?
Well done
Great platform presentation. Well done. You came across very well and answered questions calmly and collectedly.
Well done on the presentation!
Great to see your talk in the President's round today