Asthma Management in British South Asian Children: An Application of the Candidacy Framework to an Understanding of Barriers to Effective and Accessible Asthma Care

Asthma is one of the commonest chronic conditions of childhood, placing a significant burden of care on families, communities and health services. British South Asian (Indian, Pakistani, Bangladeshi origin) children diagnosed with asthma are less likely to receive reliever and preventer medication prescriptions compared to their White British counterparts; are more likely to suffer uncontrolled symptoms; and are more likely to be admitted to hospital with acute asthma exacerbations. This paper explores the socio-cultural context of asthma management in British South Asian families, drawing on major qualitative study of management and interventions for asthma management funded by the UK National Institute for Health Research, Health Services Research (NIHR-HSR) Programme.

 

We present findings from data exploring parents’/carers’/ children’s and health professionals’ understandings of asthma and their perceptions of the barriers and facilitators to good asthma management. The paper draws upon an interpretive analysis derived from the candidacy framework for explaining inequalities in access to health services for vulnerable groups, developed by Dixon-Woods and colleagues in the UK (Dixon-Woods et al. 2006). The candidacy framework emphasises the dynamic, multi-dimensional and contingent character of health-care access and provides an insightful interpretation of our findings in light of the social patterning of perceptions of asthma and health services. Our analyses using this conceptual framework demonstrate how a lack of alignment between the priorities and competencies of British South Asian families and the organization of health services conspire to create vulnerabilities and difficulties in effectively managing childhood asthma.

 

Funding acknowledgement and Disclaimer: This project was funded by the NIHR-HSR programme (Ref 09/2001/19). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the NIHR HSR programme or the Department of Health. The paper is presented by the authors on behalf of the wider MiA project team.