Policy-Practice Gaps in the Management of Asthma in Children in a Developing Country: Indonesia Experience

Objective. Sub-optimal management of childhood asthma in developing countries has been a recognized issue for decades. Our study aimed to evaluate actual practice in the management of asthma among pediatricians in Indonesia and identify gaps to the national guideline. Methods. We conducted an online survey involving 1386 pediatricians from 37 of 38 provinces in Indonesia, representing 28.8% of the pediatricians registered in the Indonesian Pediatric Society. Results. While nebulizers and inhaled reliever medications were widely available, inhaled corticosteroids medications and spirometer were scarce. Only 16.2% of pediatricians used spirometer to support the diagnosis. Meanwhile, routine blood counts and chest X-ray were commonly performed, and nearly 90% of pediatricians reported prescribing oral short acting β2-agonist as relievers, which is inconsistent with guidelines. Conclusion. There are significant gaps between national guidelines and actual practices in childhood asthma management in Indonesia, which may be due to disparities and barriers to medication access.