{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:22:20Z","timestamp":1785403340850,"version":"3.56.0"},"reference-count":33,"publisher":"AOSIS","issue":"0","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Chronic kidney disease (CKD) is a significant public health concern in KwaZulu-Natal (KZN), exacerbated by a high burden of HIV, diabetes and hypertension, and compounded by socioeconomic barriers that limit access to preventative healthcare. With KZN accounting for 20% of South Africa\u2019s dialysis patients, strengthening CKD management at the primary healthcare (PHC) level is crucial.\n\nAim: The study used a qualitative phenomenological approach to explore healthcare providers\u2019 (HCPs) lived experiences with CKD management in PHC settings in KZN, focusing on perceived barriers, facilitators and implementation realities.\n\nMethod: A qualitative phenomenological approach was used to explore the lived experiences of HCPs managing CKD in PHC settings in KZN, South Africa. Through semi-structured interviews, the study examined perceived barriers, facilitators and real-world challenges influencing the implementation of CKD interventions and guideline adherence.\n\nResults: The study uncovered five key themes reflecting HCPs experiences with CKD guideline implementation at the PHC level: inconsistent guideline awareness and adherence, inadequate training, challenges in early detection because of limited resources, the importance of team-based care and patient involvement, and broader systemic and community-level barriers. Participants underscored the need for improved training, resource allocation and integrated care approaches.\n\nConclusion: Implementation gaps stem from limited awareness, inadequate training and systemic barriers. Strengthening early detection, capacity building and team-based care is key to improving CKD management in PHC.\n\nContribution: The study offers practical insights into implementation challenges, guiding policymakers and PHC managers in enhancing CKD care in resource-limited settings.<\/jats:p>","DOI":"10.4102\/hsag.v30i0.2950","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T08:05:12Z","timestamp":1756973112000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lived experiences of CKD care in KZN: Barriers, facilitators, and practical realities"],"prefix":"10.4102","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0889-9623","authenticated-orcid":false,"given":"Verosha","family":"Ramkelawan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2704-8763","authenticated-orcid":false,"given":"Pretty","family":"Mbeje","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4096-8193","authenticated-orcid":false,"given":"Ntombifikile G.","family":"Mtshali","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04qzfn040","id-type":"ROR","asserted-by":"publisher"}],"name":"University of KwaZulu-Natal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Abe, M., Hatta, T., Imamura, Y., Sakurada, T. & Kaname, S., 2025, \u2018Examine the optimal multidisciplinary care teams for patients with chronic kidney disease\u2019, Kidney Research and Clinical Practice 44(2), 249\u2013264. https:\/\/doi.org\/10.23876\/j.krcp.23.026","DOI":"10.23876\/j.krcp.23.026"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Almaqhawi, A., 2024, \u2018Knowledge and competence regarding the management of chronic kidney disease among family medicine professionals in the Eastern Province of Saudi Arabia: A cross-sectional study\u2019, International Journal of Environmental Research and Public Health 21(7), 880. https:\/\/doi.org\/10.3390\/ijerph21070880","DOI":"10.3390\/ijerph21070880"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Ayat Ali, A.S., Lim, S.K., Tang, L.Y., Rashid, A.A. & Chew, B.H., 2021, \u2018The effectiveness of nurse-led self-management support program for people with chronic kidney disease stage 3\u20134 (CKD-NLSM): Study protocol for a randomized controlled trial\u2019, Science Progress 104(2), 368504211026159. https:\/\/doi.org\/10.1177\/00368504211026159","DOI":"10.1177\/00368504211026159"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Bartlett, A.H., Sonya, M., Samantha, R., Mary, K.S., Lauren, H., Craig, A.U. et al., 2023, \u2018Use of clinical pathways integrated into the electronic health record to address the coronavirus disease (COVID-19) pandemic\u2019, Infection Control and Hospital Epidemiology 44(2), 260\u2013267. https:\/\/doi.org\/10.1017\/ice.2022.64","DOI":"10.1017\/ice.2022.64"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Bello, A.K., Levin, A., Lunney, M., Osman, M.A., Ye, F., Ashuntantang, G.E. et al., 2019, \u2018Status of care for end stage kidney disease in countries and regions worldwide: International cross sectional survey\u2019, BMJ 367, l5873. https:\/\/doi.org\/10.1136\/bmj.l5873","DOI":"10.1136\/bmj.l5873"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Chen, T.K., Knicely, D.H. & Grams, M.E., 2019, \u2018Chronic kidney disease diagnosis and management: A review\u2019, JAMA 322(13), 1294\u20131304. https:\/\/doi.org\/10.1001\/jama.2019.14745","DOI":"10.1001\/jama.2019.14745"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Chironda, G. & Bhengu, B., 2019, \u2018Barriers to management of chronic kidney disease (CKD) in a renal clinic in KwaZulu-Natal Province, South Africa \u2013 A qualitative study\u2019, International Journal of African Nursing Sciences 10, 116\u2013123. https:\/\/doi.org\/10.4102\/hsag.v23i0.1104","DOI":"10.1016\/j.ijans.2019.04.001"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Francis, A., Harhay, M.N., Ong, A.C.M., Tummalapalli, S.L., Ortiz, A., Fogo, A.B. et al., 2024, \u2018Chronic kidney disease and the global public health agenda: An international consensus\u2019, Nature Reviews. 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