Challenges for primary caregivers during the COVID-19 pandemic in accessing health care of children with chronic diseases under periodic follow-up at a tertiary care hospital in South India

Introduction: Challenges faced by the primary caregivers during the COVID-19 pandemic help to identify their needs and health seeking behavior during pandemic. Objectives: (1) To describe the factors associated with periodic follow-up at the hospital which posed as difficulties to their primary caregivers during the COVID-19 pandemic. (2) To identify the measures adopted by these primary caregivers to overcome those difficulties. Materials and Methods: This hospital-based cross-sectional observational study was conducted from May to August 2021 among 57 primary caregivers of children with chronic diseases registered before March 1, 2020, who were under periodic follow-up in our pediatrics department. Data were collected by direct or telephonic interview using a predesigned semi-structured questionnaire and analyzed using descriptive and inferential statistics like mean, standard deviation, proportions and paired "t"-test using Epi info and IBM SPSS trial version 28.0. Results: Frequency of hospital visits of 14 (24.6%) subjects were reduced during the COVID pandemic compared to the prepandemic period. During the COVID pandemic, 42 (73.7%) subjects had faced transportation difficulties, 23 (40.3%) had faced financial difficulties, 22 (38.6%) had skipped their scheduled follow-up visits and around 31.6% of them have feared of contracting COVID. None had availed telemedicine consultation for their children either before or during the pandemic. Conclusions: Difficulties faced in transportation, fear of contracting COVID, financial difficulties, and lack of awareness of teleconsultation services were identified as their major obstacles.