An Ethnographic Study of a Clean Air Action Plan and Paediatric Asthma Hospitalisations in Casablanca’s Industrial Zone, 2016

The industrial zone of Casablanca has historically suffered from poor air quality, linked to a significant burden of paediatric respiratory illness, particularly asthma. The specific social and healthcare impacts of policy interventions to address this issue remain insufficiently explored. This ethnographic study aimed to understand the lived experiences and perceived health impacts associated with the implementation of a clean air action plan in Casablanca’s industrial zone. It sought to explore community and healthcare professional perspectives on changes in paediatric asthma hospitalisations and related care practices. An ethnographic approach was employed, involving continuous fieldwork. Data collection included participant observation in two primary healthcare centres and a paediatric hospital ward, supplemented by 45 in-depth interviews with caregivers of asthmatic children, general practitioners, paediatricians, and community health workers. Field notes and interview transcripts were analysed using thematic analysis. Analysis revealed a dominant theme of cautious optimism tempered by scepticism regarding the plan’s efficacy. Healthcare professionals reported a perceived reduction in severe asthma exacerbations requiring hospitalisation, with several estimating a notable decrease in such cases. Caregivers, however, emphasised persistent concerns about pollution spikes and the financial burden of chronic disease management, which continued to shape health-seeking behaviour. The clean air action plan was associated with a perceived positive shift in paediatric asthma outcomes by local health providers. The study underscores how broader socio-economic factors and enduring environmental concerns continue to fundamentally influence childhood asthma management in this industrial community. Future air quality policies should integrate robust community engagement strategies to build public trust. Public health programmes must concurrently address economic determinants of health, such as medication costs, to optimise the benefits of environmental interventions. Long-term, systematic monitoring of health outcomes alongside air quality data is essential. air pollution, public health policy, paediatric asthma, hospitalisations, ethnography, Morocco, community health, environmental health This study provides an in-depth, contextual understanding of how an environmental health intervention is perceived and experienced within a vulnerable community and its healthcare system, highlighting critical intersections between policy, clinical practice, and socio-economic reality.