Psychosocial Impact of Childhood Chronic Illness on Caregivers in Kano State, North West Nigeria: A Mixed-Methods Study

Caregiving for children with chronic illnesses such as sickle cell disease, epilepsy, and chronic kidney disease places enormous psychosocial strain on families in low-resource settings, yet caregiver mental health remains poorly addressed in Nigerian paediatric care. This mixed-methods study examines the psychosocial impact of childhood chronic illness on primary caregivers attending specialist paediatric clinics at Aminu Kano Teaching Hospital, Kano State, North West Nigeria. A total of 210 caregivers of chronically ill children completed the Depression, Anxiety and Stress Scale (DASS-21) and a structured questionnaire on care burden, social support, and economic impact. Qualitative data were collected through 20 purposively selected in-depth interviews with caregivers. Quantitative results indicated that 48.6% of caregivers had clinically significant depression, 42.4% had anxiety, and 35.2% had moderate to severe stress. Loss of employment due to caregiving obligations was reported by 39.5% of participants. Social isolation was described as a dominant theme in qualitative narratives, compounded by stigma associated with the child's diagnosis. Spiritual coping was the most commonly reported resilience strategy. Formal psychosocial support services were accessed by fewer than 10% of caregivers. The study highlights the invisible burden carried by caregivers and calls for integrating psychosocial screening and counselling into paediatric chronic disease clinics. Keywords: caregiver burden, chronic illness, psychosocial impact, Kano State, North West Nigeria.