The 'Management Pathway' (MP) for congenital heart disease (CHD) comprises diagnostic, treatment, and follow-up phases. Potential risk factors for failure to receive optimal care (OC) include lower levels of parent/guardian education and income, as well as poor access to healthcare facilities. The objective of the current study was to identify risk factors for failure to receive OC in pediatric patients under 12 years of age with CHD. Patients were consecutively recruited over a one-year period from the general pediatric wards at Kenyatta National Hospital (KNH), Nairobi. All patients required intervention (surgery/cardiac catheterization) and were followed up for one year post-recruitment. Data collected included the level of parent/guardian education, income, and degree of travel impedance. Age at diagnosis was used as the endpoint for risk-factor analysis regarding failure to receive optimal care. Forty-nine patients were recruited, with over 95% of parents/guardians having some level of education, and nearly 40% having received a tertiary education. Less than 10% of parents/guardians belonged to income level 4 (high), while the majority (over 40%) were at income level 3 (high-middle). Regarding late diagnosis (LD), the odds ratios were 0.6 (95% CI: 0.4955 to 0.8665; p-value = 0.0030) and 1.0188 (95% CI: 0.9967 to 1.0415; p-value = 0.0965) for the level of education and income level, respectively. A lower level of parent/guardian education was identified as a risk factor for LD, whereas a lower income level was not associated with LD. The level of parent/guardian education may potentially influence the risk of failure to receive OC.

 

Key words: Congenital heart disease, diagnosis surgery follow-up, optimal care, lower level of parent education.