Pulmonary Rehabilitation for Chronic Respiratory Diseases: Views of Healthcare Professionals and Policymakers in Bangladesh

Introduction: Chronic respiratory diseases (CRDs) are common but often neglected in low- and middle-income countries (LMICs), where pulmonary rehabilitation (PR) remains underused despite its proven benefits. In this study, we aimed to explore the perspectives of healthcare professionals who may have limited or no awareness of PR, as well as influential stakeholders who could hinder its implementation in Bangladesh, and to identify strategies for promoting and implementing PR in the country. Method: We recruited a purposive sample of healthcare professionals and policymakers from four administrative divisions in Bangladesh: Dhaka, Chittagong, Rajshahi, and Khulna. Data were collected through semi-structured interviews conducted between January and June 2024, using an interview topic guide. A thematic analysis was performed to synthesise the findings. Preliminary Results: Interviews were conducted with 10 policymakers (four at national and six at regional level) and 30 healthcare professionals (HCPs) from diverse backgrounds (pulmonologists, internists, GPs, private and public sector practitioners). Policymakers highlighted that patients and HCPs often have minimal expectations and are generally satisfied with modest outcomes. Consequently, PR is perceived as a secondary, aftercare service, which limits its prominence and integration into routine care. Government priorities are shaped by public demand, further relegating PR to a low-priority status. HCPs emphasised time constraints and the limited availability of PR services as significant barriers to its uptake, underscoring systemic challenges in implementing PR within existing healthcare structures. They have also focused the need to integrate PR in the medical educational programme and create an accountability of providing PR as WHO recommended in routine clinical practice. Discussion: The expectations of healthcare professionals and patients should extend beyond acute care, focusing on managing the long-term impact of the disease. This shift can create a stronger demand for comprehensive aftercare, including pulmonary rehabilitation, ensuring its effective implementation.