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. Author manuscript; available in PMC: 2024 Aug 29.
Published in final edited form as: Hemato. 2021 Nov 28;2(4):713–726. doi: 10.3390/hemato2040048

Table 2.

Summary of findings.

Selected Codes Sub-Themes Themes

  • Getting SCD is God’s will

  • SCD patients do not survive

  • Is a disease of poor people

 Parent’s myth and misconceptions regarding SCD Individual barriers

  • Patients doubt on HU that it causes cancer and infertility

  • Patients read and know the side effects of HU

  • Patients are not aware of HU uses that affect adherence

  • The cost of HU affect compliance

 Medical doctors worries and fears to prescribe HU

  • Shortage of lab machine for reticulocyte count

  • Absence of paediatric formulation

  • Lab tests are only available in a tertiary hospital

  • Some facilities are not allowed to have HU

 Lack of infrastructural support Health facility barriers

  • A special permit is needed to access HU

  • Few pharmacies sell HU

  • Not available in most health facilities

  • Few pills are provided per visit

 Limited availability of HU in health facilities

  • Permit delay initiation of HU to patient

  • HU is covered by insurance after 1 year of use

  • Some insurance scheme does not cover HU

  • Insurance bureaucracy at initiation

  • Insurance agencies are profit-oriented

 Limitations of HU insurance coverage Health system barriers

  • HU cost is high

  • Variation in HU price

  • I skip sometimes due to cost

 High cost of HU

  • HU being recognized as anticancer

  • Restrictions of HU to be used in SCD

 Restrictive policy on the use of HU

  • The disease is not contagious

  • SS is an inherited disease

  • HU raise blood amount

  • HU use reduces the frequency of hospital visits

 Parent’s awareness of the disease and the use of HU Having adequate knowledge of the SCD

  • SCD is a genetic disorder

  • SCD is an inherited disease from both parents

  • HU prevent SCD crisis

  • HU reduce morbidity

 Medical doctors’ knowledge about SCD and the use of HU in its management

  • Insurance help on HU accessibility

  • Insurance reduces the cost of HU

  • Insurance coverage raise HU adherence

 Readiness of Health Insurance to cover or to offer special permit for HU Opportunities for HU access to patients with SCD

  • Being available in HF without restrictions

  • HU is available in community outlets

  • Availability in private health facilities

 Availability of HU in health facilities