471 understanding burn care challenges in resource constraint settings: A qualitative study from south Asia

Introduction: Burn injury causes more than three-fourth deaths in Africa, Eastern Mediterranean and South- Asian regions, however, lack of resources pose challenge is seeking and provision of burn care. The study objective was to understand challenges faced by burn patients and providers in South Asia and strategies to overcome them.Methods: The qualitative study was conducted at two main burn centers in Bangladesh and Pakistan between December 2014-January 2015. After taking informed consent, 32 in-depth-interviews (IDIs) with patients and eight focused group discussions (FGDs) with providers were conducted. Each FGD had on average 6–7 participants. The IDIs and FGDs were conducted at the burn centers. Data was recorded, transcribed verbatim and analyzed based on emerging themes related to challenges in seeking burn care and its provision, and strategies to overcome these challenges.Results: Common challenges identified were: 1) lack of resources at current burn centers which include trained providers, medicine and supplies and latest treatment options; 2) lack of new specialized burn care center resulting in increased patient load on the existing centers; 3) overcrowding of centers due to reduce cost of care towards patients; 4) delay in seeking burn care due to preponderance for traditional healers; 5) lack of financial resources available to people from low-income strata and those living in rural areas; and 6) lack of rehabilitation services specific to burns. Common strategies to overcome barriers were: 1) training of local primary care providers and traditional healers as they are usually the first point of contact; 2) specialized burn care training and hiring of care providers including nurses, doctors, paramedical staff; 3) community awareness programs regarding places to seek burn care to avoid delay in burn treatment; 4) media campaigns on first aid care following burns to reduce severity of burn and dispel myths like use of tooth-paste; 5) provision of rehabilitation services including psychological support.Conclusions: Lack of awareness among masses regarding burn care and limited resources need to be addressed to improve burn care seeking and provision resource constraint settings.|Applicability of Research to Practice: This work can guide development and implementation of burn care programs involving multiple levels of healthcare system, a much-needed approach in developing countries