Addressing Barriers to Health Care Access of Congenital Heart DiseasePatients in Guyana

摘要

In order to mitigate the late presentation and resulting poor outcomes ofchildren with advanced cardiac disease, the Ministry of Public Health (MOPH) inGuyana has expressed interest in identifying ways to improve access to healthcare for these children. The goal of this study was to identify barriers facedby CHD patients and their families in accessing pediatric cardiology services inGuyana, and to identify limitations to the diagnosis and referral of CHDpatients by health care professionals. Two surveys were used to gain insightinto the experiences of practicing health care professionals and the parent(s)or guardian(s) of children with CHD. Patients were identified based onconvenience sampling at cardiology clinics and outreach clinics in both urbanand rural Guyana. Physicians were identified using convenience sampling athealth posts in rural Guyana. Fifty-two (n = 52) families were identified andinterviewed throughout the regions visited. The majority of families identifieddistance, the need to travel, and their inability, financially and practically,to attend clinic as the main barrier to accessing specialized care. Twelve(n = 12) health care providers were interviewed. They identified limitedknowledge surrounding the diagnosis and management of CHD, and perceivedimpracticality of referring patients to specialized services, despite beingaware of the referral process. This study identifies the need for improvedoutreach and support for health care providers and families, especially thoseliving in rural communities. It identifies some of the challenges faced inmanaging patients with CHD in Guyana, while establishing specific areas forquality improvement.