Purpose In Feb 2018, UNICEF and the Mongolian National Center for Public Health released a report that called for urgent action in treating and preventing the country’s growing number of childhood respiratory illnesses. According to a 2009 study conducted by Arisaka et al, childhood asthma affects roughly 20% of children aged 6-7 years in Ulaanbaatar, Mongolia. The prevalence is higher than estimates previously stated by the ISAAC for both the world and Asia-Pacific countries. No studies have been conducted to evaluate perceptions and attitudes towards asthma and barriers to providing pediatric asthma treatment and management among Mongolian providers. Given the high rates of respiratory illnesses and worsening pollution in Ulaanbaatar, we feel that this study will fill a current void in research and provide a useful contribution to improving asthma management among Mongolian children. Methods We designed a questionnaire aimed to assess provider perceptions and attitudes surrounding asthma as well as evaluate barriers to asthma management. Focus groups of pediatric providers in Mongolia were assembled for the administration and discussion of the questionnaire. Given that there are primary, secondary and tertiary levels of care centers in Mongolia, a pilot focus group of providers working in facilities of all three levels of care was assembled. A medical doctor and public health professor was identified to serve as a translator for the focus group. Results Discussion among providers in the pilot focus group revealed numerous barriers to diagnosis of asthma in children, most notably that a formal diagnosis will only be made in patients seen at the sole tertiary health facility for children in Ulaanbaatar, Mongolia. Providers at all levels emphasized the lack of available treatment medications and resources to improve patient compliance. As a result, providers are not able to follow WHO guidelines for asthma treatment and management. Focus group discussion also shed light on providers’ attitudes and perceptions surrounding asthma including the misconception that asthma is the result of pesticides in food. Conclusion Focus group discussions identified a lack of tools and medications for providers to diagnose asthma in children. Additionally, lack of medications plays a significant role in medication noncompliance and improved asthma control. All providers identified asthma and increasing rates of respiratory illnesses as a major problem, however notable misconceptions prevented appropriate prevention recommendations and treatments. Additional focus groups will be conducted in order to generate key conclusions that can be used to make culturally sensitive as well as practically achievable recommendations to improve asthma diagnosis and management as well as correct misconceptions and fill knowledge gaps of Mongolian providers. As Mongolia is facing a public health crisis centering on air pollution, the importance of interventions regarding respiratory conditions and illnesses among children have never been more critical.
Attitudes and Perceptions of Providers in Mongolia towards Pediatric Asthma Diagnosis and Management
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Lauren Mills, Karolina Grekov, Alexa Monroy, David Warburton; Attitudes and Perceptions of Providers in Mongolia towards Pediatric Asthma Diagnosis and Management. Pediatrics July 2020; 146 (1_MeetingAbstract): 271–272. 10.1542/peds.146.1MA3.271
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