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The burden of chronic illnesses is rising throughout the world but information on barriers to managing such diseases in developing countries is scarce. Qualitative data from focus group discussions and interview transcripts from a longitudinal study involving 22 households in urban, coastal Kenya were analysed. Themes around barriers to chronic illness care were identified and a conceptual framework developed which described relationships between these themes. The main barrier to chronic illness management was the cost of care. Other barriers identified were patient knowledge and beliefs, stigma, quality and trust in providers and long care pathways. Household resilience was adversely affected by chronic illness, further reducing households' ability to cope with illness. Policy options to address the barriers identified are discussed. Copyright © 2009 John Wiley & Sons, Ltd.

Original publication




Journal article


Journal of International Development

Publication Date





271 - 290