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Heart Failure Care Facilitators and Barriers in Rural Haiti: A Qualitative Study
Gene F Kwan1,2, Elizabeth Basow3, Benito D Isaac4
1Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center & Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Annals of Global Health
|September 30, 2024
Summary
Access to chronic heart failure (HF) care in rural Haiti is influenced by patient knowledge, social support, and trust in the healthcare system. Misconceptions about medication, food insecurity, and non-healthcare costs create significant barriers to consistent HF management.
Area of Science:
- Global Health
- Public Health
- Cardiology
Background:
- Heart failure (HF) is a significant cause of hospitalization in Haiti.
- Limited understanding exists regarding factors influencing chronic HF care access post-discharge.
- Few patients with HF return for essential outpatient follow-up care.
Purpose of the Study:
- To explore patient perspectives on facilitators and barriers to accessing chronic heart failure care.
- To identify key factors influencing continuity of care for heart failure patients in rural Haiti.
Main Methods:
- Qualitative descriptive study involving 13 heart failure patients.
- Data collected through three group and one individual interview.
- Thematic analysis using emergent coding, structured by the socioecological model.
Main Results:
- Facilitators include knowledge of HF treatment, social support, low care costs, medication accessibility, and trust in the healthcare system.
- Barriers include misconceptions about medication adherence, food insecurity impacting adherence, lack of social support, prohibitive non-healthcare costs, and negative clinic experiences.
- Beliefs in supernatural causes of heart disease also present a barrier to seeking care.
Conclusions:
- Several facilitators and barriers significantly impact chronic HF care in rural Haiti.
- Interventions should address misconceptions about HF management and enhance patient support systems for adherence.
- Leveraging spiritual beliefs may improve patient engagement with healthcare services.
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