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Managing low-back pain in rural Uganda: a qualitative study exploring the perspectives and practices of frontline health workers regarding LBP management in primary care.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2000-
    • Subject Terms:
      Primary Health Care* ; Low Back Pain*/therapy ; Low Back Pain*/diagnosis ; Qualitative Research* ; Focus Groups*; Humans ; Uganda/epidemiology ; Female ; Male ; Adult ; Rural Population ; Health Personnel ; Attitude of Health Personnel ; Middle Aged
    • Abstract:
      Background and Aims: Low-back pain (LBP) is the main cause of years lived with disabilities (YLDs) worldwide and the second cause of YLDs in Uganda. In 2019, it was responsible for 7.4% of global YLDs and 5% of YLDs in Uganda. LBP takes a significant toll on people's quality of life and disproportionately affects lower socioeconomic classes, elders, and women. In rural Uganda, LBP is managed in health centres by clinical officers and nurses with limited resources. This study aims to understand the perspectives and practices of these health workers.
      Method: A qualitative design using semi-structured focus-group discussions was employed. Purposive sampling allowed us to identify relevant participants based on their roles as healthcare professionals working in primary care context in rural South-West Uganda. Data was analysed using thematic analysis.
      Findings: LBP is a common and persistent complaint among patients presenting to rural health centres in Uganda. Manual labour and female specific health conditions were deemed to be common causes. There was a strong reliance on medication prescription, coupled with X-ray diagnosis, with little emphasis on education or exercise. Finally, findings highlighted major barriers for patients within the referral system to hospital care or rehabilitation.
      Discussion: Education and training of frontline clinicians in terms of appropriate prescribing and rehabilitation for LBP is crucial. Evidence-based rehabilitation interventions need to be developed and adapted so that they can be delivered within the time and resource constraints of the health workforce, ensuring that they are acceptable and effective to patients in the context of rural Uganda.
      Competing Interests: Declarations. Ethics approval and consent to participate: This study received ethical approval from the Mbarara University of Science and Technology Research Ethics Committee (MUST-2022-540) and from the Human Research Ethics Committee at University College Dublin (LS-LR-22-227-OSullivan). All participants were provided with an information leaflet that was approved by both above-mentioned ethics committees detailing the purpose of the study. Therefore, their consent was informed. All participants signed a written consent form to participate in it. The present study is compliant with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
      (© 2024. The Author(s).)
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    • Grant Information:
      Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland; Grant 21/FIP/SDG/9960 Ireland SFI_ Science Foundation Ireland
    • Contributed Indexing:
      Keywords: Care pathways; Health System; Low-Back Pain; Musculoskeletal Management; Primary care
    • Publication Date:
      Date Created: 20250219 Date Completed: 20250220 Latest Revision: 20250223
    • Publication Date:
      20250223
    • Accession Number:
      PMC11837481
    • Accession Number:
      10.1186/s12891-024-08164-9
    • Accession Number:
      39972436