Key result
Financial hardship, high workload, and supply shortages impede kidney disease screening in Uganda.
Why the study?
Kidney disease screening allows early intervention among high-risk patients with hypertension or diabetes, but screening remains suboptimal in low- and middle-income countries.
Healthcare providers in Uganda face substantial systemic, provider-level, and patient-level barriers to screening for kidney disease in high-risk patients, highlighting the need for improved resources, education, and peer-support systems.
May inform local strategies to address screening barriers in Uganda; leaves open their impact on uptake in prospective studies.
Background: Screening for kidney disease (KD) among high-risk patients (patients with hypertension or diabetes) allows early diagnosis, intervention and delayed progression of the disease. In low- and middle-income countries (LMIC), KD screening is still sub-optimal. This study explored the healthcare providers' perceived barriers and facilitators to KD screening among older adults with hypertension and diabetes in Mbarara southwestern Uganda. Methods: This was a descriptive qualitative study among healthcare providers caring for older adults with diabetes mellitus and hypertension at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed to develop themes of barriers and facilitators. Results: We conducted 30 in-depth interviews among healthcare providers. Barriers to screening for kidney disease included patient related factors according to healthcare providers (financial hardships, poor health seeking behavior, limited knowledge and awareness), healthcare factors (work overload, ineffective patient healthcare provider communication) and system/policy related factors (lack of laboratory supplies, lack of guidelines and poor medical record keeping and documentation). With respect to facilitators, we found formation of peer support groups, effective team, and continuous medical education (CME). Conclusion: Healthcare providers encounter substantial but modifiable barriers in screening older adults for KD. The identification of barriers and facilitators in timely KD detection gives us an outlook of the problem in Uganda and leads for proposals of action. Interventions that address these barriers and promote facilitators may improve the healthcare provider's effectiveness and capacity to care including screening for patients at risk of KD.
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Owokuhaisa et al. (2024) studied Barriers to Kidney Disease Screening (n=30). Kidney disease screening practices was evaluated on Perceived barriers and facilitators to kidney disease screening. Healthcare providers identified financial hardships, work overload, and lack of supplies as major barriers to kidney disease screening in Uganda.
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