Barriers and Facilitators of Use of Hydroxyurea among Children with Sickle Cell Disease: Experiences of Stakeholders in Tanzania
Manase Kilonzi,
Hamu J. Mlyuka,
Fatuma Felix Felician,
Dorkasi L. Mwakawanga,
Lulu Chirande,
David T. Myemba,
Godfrey Sambayi,
Ritah F. Mutagonda,
Wigilya P. Mikomangwa,
Joyce Ndunguru,
Agnes Jonathan,
Paschal Ruggajo,
Irene Kida Minja,
Emmanuel Balandya,
Julie Makani,
Nathanael Sirili
Affiliations
Manase Kilonzi
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Hamu J. Mlyuka
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Fatuma Felix Felician
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Dorkasi L. Mwakawanga
School of Nursing, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Lulu Chirande
School of Medicine, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
David T. Myemba
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Godfrey Sambayi
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Ritah F. Mutagonda
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Wigilya P. Mikomangwa
School of Pharmacy, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Joyce Ndunguru
School of Medicine, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Agnes Jonathan
School of Medicine, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Paschal Ruggajo
School of Medicine, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Irene Kida Minja
School of Dentistry, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Emmanuel Balandya
School of Medicine, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Julie Makani
School of Medicine, The Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
Nathanael Sirili
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65013, Tanzania
Factors contributing to low use of HU among SCD patients exist in high-income countries. The latter leaves a drift of literature on factors for low utilization of HU in developing countries. This study aimed to explore the factors influencing the use of HU in the management of SCD in Tanzania. A qualitative study was employed to interview purposively selected participants for this study. The in-depth interviews were conducted with 11 parents of children with SCD, four medical doctors working at sickle cell clinics, and two representatives of the national health insurance fund (NHIF). Interviews were audio-recorded, transcribed, and thematically analysed. Barriers identified were misconception of parents on SCD, financial constraints, regulatory restrictions, worries and fears of medical doctors on the acceptability of HU, shortages of laboratory equipment and consumables, and limited availability of HU. Adequate knowledge of the parents and medical doctors on SCD and HU and opportunities for HU accessibility were the facilitators identified. The utilization of HU by the individual with SCD is affected by several factors, from individual to policy level. Nevertheless, parents of children with SCD and medical doctors working in sickle cell clinics demonstrated good knowledge of the diseases and HU.
