Teachers' perceptions of asthma care in Sub-Saharan Africa: A cross-country qualitative analysis

Abstract

Background Asthma is the most common chronic respiratory disease among children and adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers' perceptions of asthma care across six African countries. Methods We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Accra (Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. Results We identified two key themes related to asthma care: (1) barriers to asthma care and (2) suggestions to improve the care of asthma learners. Teachers reported a lack of knowledge and skills among themselves, learners, and caregivers. Some teachers believed that myths about asthma and restrictions on themselves administering care exacerbated challenges faced by learners with asthma. Most teachers identified a need for all-inclusive asthma training programmes for teachers, learners and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Recommendations were made for annual screening to enable early identification of learners with asthma and clarity on restricting teachers administering asthma medications. Conclusions Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.