{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T19:04:10Z","timestamp":1763060650462,"version":"3.45.0"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) is a growing public health problem in Ethiopia. However, evidence on the health system and contextual factors influencing CKD care remains limited. This study explored the barriers and facilitators to CKD care from the perspectives of healthcare providers and other stakeholders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive qualitative study was conducted using purposive and maximum variation sampling to recruit healthcare providers (including general practitioners, nephrologists\/internists, nurse) and non-communicable disease (NCD) officers and program coordinators. Interviews were audio recorded, transcribed, and thematically analysed, underpinned by the Theoretical Domains Framework version 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifteen participants (six general practitioners, five nephrologists\/internists, one nurse, and three NCD program officers and coordinators) were included. About 40% of participants had over six years\u2019 experience. Key barriers to CKD care included patient misconceptions, low patient and healthcare provider awareness, shortage of health workforce, knowledge gaps among junior healthcare providers, limited resources, high out-of-pocket costs, absence of registries for CKD, weak referral systems, inconsistent access to medicines and diagnostics, lack of structured training, and conflict-related disruptions. Facilitators included adherence to guidelines by senior staff, inclusion of CKD into national non-communicable disease strategies, and increased use of media for public health education.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Addressing key barriers and enhancing prioritisation of CKD by clinicians and policymakers is critical. Strengthening workforce capacity, awareness, referral systems, and integration into national strategies offers opportunities to improve CKD care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0336781","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:51:47Z","timestamp":1763059907000},"page":"e0336781","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Stakeholders\u2019 perspectives on barriers and enablers of chronic kidney disease care in Ethiopia: A qualitative study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-7814","authenticated-orcid":true,"given":"Daniel Bekele","family":"Ketema","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Jun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sradha","family":"Kotwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Workagegnehu","family":"Hailu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Gallagher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohina","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"pone.0336781.ref001","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/978-3-030-56890-0_4","article-title":"Nephrology in Ethiopia","author":"AM Ejigu","year":"2021","journal-title":"Nephrology Worldwide"},{"issue":"3","key":"pone.0336781.ref002","doi-asserted-by":"crossref","first-page":"51","DOI":"10.7812\/TPP\/08-082","article-title":"SERVE Ethiopia","volume":"13","author":"PJ Tuso","year":"2009","journal-title":"Perm J"},{"issue":"5","key":"pone.0336781.ref003","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0194819","article-title":"Prevalence of high bloodpressure, hyperglycemia, dyslipidemia, metabolic syndrome and their determinants in Ethiopia: Evidences from the National NCDs STEPS Survey, 2015","volume":"13","author":"YF Gebreyes","year":"2018","journal-title":"PLoS One"},{"key":"pone.0336781.ref004","first-page":"7","article-title":"Population based survey of chronic non-communicable diseases at gilgel gibe field research center, southwest ethiopia","volume":"22","author":"AT Muluneh","year":"2012","journal-title":"Ethiop J Health Sci"},{"issue":"1","key":"pone.0336781.ref005","first-page":"1","article-title":"Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990\u20132019: results from the global burden of disease study 2019","volume":"23","author":"C Ke","year":"2022","journal-title":"BMC Nephrology"},{"issue":"3","key":"pone.0336781.ref006","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1038\/sj.ki.5002343","article-title":"Chronic kidney disease as a global public health problem: approaches and initiatives - 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