(198) Qualitative Assessment on Access to Treatment and Perceived Challenges Among Asthma Patients in a Hill Village of Nepal

Publication Number: 1191

Background: Bronchial asthma continues to be a problem in Nepal. The affected individuals’ perceptions of bronchial asthma about how the disease has impacted their lives, the perceived socio-economic impact, and access to treatment remain unexplored.

Objectives: To explore the impact of bronchial asthma on patients' lives in a hill village in Syangja district, Nepal, and to obtain information about how patients access treatment and their challenges.

Methods: It was an explorative qualitative study conducted among asthmatic patients. The study site is the village of Jyamire (located at an altitude between 900 to 1200 m) Syangja district of Nepal. Individuals suffering from asthma residing in the village and aged 18 years or above were included. Semi-structured interviews were conducted face-to-face with the respondents at their homes using an interview guide. We enrolled 11 participants in our study and tried to broadly represent the population of the study area. The interviews were audio recorded, transcribed in the Nepali language, and then translated into English for further analysis. We used a mixture of directed and conventional content analysis to identify the main themes and areas to be explored. A mixture of inductive and deductive approaches was used. Within the main categories, a conventional content analysis process was used to explore categories that emerged from the data. The interview was concluded once no new themes or subthemes emerged.

Results: Most participants were female, between 18 to 60 years of age, and housewives. Most houses were built of mud and poorly ventilated. Gas was used for cooking though firewood was also used. Most used to get an average of three serious attacks a year both during winter and summer. The themes that emerged were the impact of asthma on their lives, the knowledge of the interviewee about the disease, the impact of asthma on their socioeconomic status, and treatment and prevention of the disease. Residing in a hill village required them to walk up and down several times a day and the disease seriously impacted their lives. The smoke produced during different ceremonies and during cooking also worsened their asthma.

Conclusions: The study findings showed a negative impact of asthma on affected individuals’ life in multiple dimensions such as healthy living and social lives. The existence of multiple factors, a few unique to Nepal and a few other general well-known factors contributing to poor asthma control. Considering Nepal is a country with a high prevalence of asthma, measures must be taken to contain the negative impact of asthma on the health of individuals. As known from this study, interventions are needed beyond the pharmacological treatment aspects.