Barriers to providing quality congenital heart disease care along the care continuum
| Recognition | Diagnosis | Referral | Stabilisation and transport | Treatment | Follow-up |
| Lack of prenatal and antenatal screening protocols. Lack of availability of screening equipment and trained personnel. Inconsistent well-child visits. Inability to get remote consultation from high-level cardiac care facilities. This may be due to unavailability of telehealth-telemedicine equipment or a well-defined consultation pathway. Demands on the trained paediatric cardiologist of catering to large patient volumes may also make a teleconsultation process ineffective. | Lack of availability of diagnostic equipment, infrastructure and trained personnel. | Unable to recognise need for referral. Weak referral pathways. Lack of effective communication with referral centres. | Inconsistent access to centres equipped to recognise and stabilise patients. Inadequate transport and communication system. Untrained paramedics staff with inadequate care provided to patients during transport. | Inconsistent access to centres equipped to manage patients medically and surgically. Unavailability of required infrastructure and expertise. | Inadequate emphasis on long-term follow-up and counselling. Unavailability of remote telehealth-telemedicine platforms to streamline care. |