3403 Accessing healthcare for Parkinson’s disease in Kilimanjaro region, Tanzania: a challenge for health equity

Abstract Introduction The global prevalence of Parkinson’s disease, a common neurodegenerative disorder, is rising. Most people with Parkinson’s live in low- and middle-income countries, where accessing healthcare is challenging. A growing body of literature has investigated the distribution and experience of Parkinson’s disease in Tanzania, yet there remains a need to understand access to healthcare for the condition in this setting. This study aims to qualitatively explore the experience of accessing healthcare for Parkinson’s disease in northern Tanzania’s Kilimanjaro region. Method Twenty-seven semi-structured interviews were conducted with people with Parkinson’s (n = 12), caregivers (n = 8), and healthcare professionals involved in care (n = 7). People with Parkinson’s and caregivers were recruited to achieve wide variation in demographic and health characteristics. Professionals varied by occupation and workplace. Direct observation of clinical settings and detailed field notes captured contextual information. Reflexive Thematic Analysis was used to analyse data inductively and identify patterns of meaning across the dataset. Results Three overarching themes were defined during analysis. The Price of Parkinson’s considers the economic burden Parkinson’s disease levies against individuals, and its implications for healthcare access. Making Sense of Parkinson’s discusses how knowledge and perceptions of the condition influence healthcare access, whilst an Underprepared System describes how a healthcare system under-equipped to manage it poses barriers to accessing healthcare. Conclusions Accessing healthcare for Parkinson’s disease in Kilimanjaro region is influenced by both healthcare system and patient factors and is often challenging for those affected by the condition and those involved in healthcare. This study highlights the need for the development of effective public health interventions for Parkinson’s disease in this setting. A systems approach, focussing on care affordability, public awareness, specialist service capacity, management outside of the specialist setting, and research relating to novel diagnostics and therapeutics in Sub-Saharan Africa is recommended to improve healthcare access.