Lived experiences of CKD care in KZN: Barriers, facilitators, and practical realities

Chronic kidney disease (CKD) is a significant public health concern in KwaZulu-Natal (KZN), exacerbated by a high burden of HIV, diabetes and hypertension, and compounded by socioeconomic barriers that limit access to preventative healthcare. With KZN accounting for 20% of South Africa's dialysis patients, strengthening CKD management at the primary healthcare (PHC) level is crucial.

The study used a qualitative phenomenological approach to explore healthcare providers' (HCPs) lived experiences with CKD management in PHC settings in KZN, focusing on perceived barriers, facilitators and implementation realities.

A qualitative phenomenological approach was used to explore the lived experiences of HCPs managing CKD in PHC settings in KZN, South Africa. Through semi-structured interviews, the study examined perceived barriers, facilitators and real-world challenges influencing the implementation of CKD interventions and guideline adherence.

The study uncovered five key themes reflecting HCPs experiences with CKD guideline implementation at the PHC level: inconsistent guideline awareness and adherence, inadequate training, challenges in early detection because of limited resources, the importance of team-based care and patient involvement, and broader systemic and community-level barriers. Participants underscored the need for improved training, resource allocation and integrated care approaches.

Implementation gaps stem from limited awareness, inadequate training and systemic barriers. Strengthening early detection, capacity building and team-based care is key to improving CKD management in PHC.

The study offers practical insights into implementation challenges, guiding policymakers and PHC managers in enhancing CKD care in resource-limited settings.