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Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study

BACKGROUND: Chronic lung diseases contribute to the growing non-communicable disease (NCD) burden and are increasing, particularly in many low and middle-income countries (LMIC) in sub-Saharan African. Early engagement with health systems in chronic lung disease management is critical to maintain qu...

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Autores principales: Saleh, Sepeedeh, Bongololo, Grace, Banda, Hastings, Thomson, Rachael, Stenberg, Berthe, Squire, Bertie, Tolhurst, Rachel, Dean, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296555/
https://www.ncbi.nlm.nih.gov/pubmed/30557307
http://dx.doi.org/10.1371/journal.pone.0208188
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author Saleh, Sepeedeh
Bongololo, Grace
Banda, Hastings
Thomson, Rachael
Stenberg, Berthe
Squire, Bertie
Tolhurst, Rachel
Dean, Laura
author_facet Saleh, Sepeedeh
Bongololo, Grace
Banda, Hastings
Thomson, Rachael
Stenberg, Berthe
Squire, Bertie
Tolhurst, Rachel
Dean, Laura
author_sort Saleh, Sepeedeh
collection PubMed
description BACKGROUND: Chronic lung diseases contribute to the growing non-communicable disease (NCD) burden and are increasing, particularly in many low and middle-income countries (LMIC) in sub-Saharan African. Early engagement with health systems in chronic lung disease management is critical to maintain quality of life and prevent further damage. Our study sought to understand health seeking behaviour in relation to chronic lung disease and TB in a rural district in Malawi. METHODS: Qualitative data was collected between March-May 2015, exploring patterns of health seeking for lung disease amongst residents of two districts in rural Malawi. Participants included those with and without lung disease, health workers and village leaders. Participants with a history of TB were included in the sample due to similarities in clinical presentation and in view of potential to cause long-term damage to lung tissue. RESULTS: Our findings are ordered around a specific model of health seeking devised by adapting previous models. The model and findings span three broad areas that were found to influence health seeking: understandings of health and disease which shaped whether, when and where to seek care; the care seeking decision which was influenced by social and structural factors; and the care seeking experience which impacted future care decisions creating ‘feedback loops’. DISCUSSION: Efforts to improve effective and accessible healthcare provision for chronic lung disease need to address all the determinants of health seeking behaviour identified. This may include: enhancing the structural and financial accessibility of health services, through the strengthening of community linkages; improving communication between formal health providers, patients and communities around symptoms, diagnosis and management of chronic lung diseases; and improving the quality of diagnostic and management services through the strengthening of health systems ‘hardware’ (equipment availability) and ‘software’ (development of trusting and respectful relationships between providers and patients).
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spelling pubmed-62965552018-12-28 Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study Saleh, Sepeedeh Bongololo, Grace Banda, Hastings Thomson, Rachael Stenberg, Berthe Squire, Bertie Tolhurst, Rachel Dean, Laura PLoS One Research Article BACKGROUND: Chronic lung diseases contribute to the growing non-communicable disease (NCD) burden and are increasing, particularly in many low and middle-income countries (LMIC) in sub-Saharan African. Early engagement with health systems in chronic lung disease management is critical to maintain quality of life and prevent further damage. Our study sought to understand health seeking behaviour in relation to chronic lung disease and TB in a rural district in Malawi. METHODS: Qualitative data was collected between March-May 2015, exploring patterns of health seeking for lung disease amongst residents of two districts in rural Malawi. Participants included those with and without lung disease, health workers and village leaders. Participants with a history of TB were included in the sample due to similarities in clinical presentation and in view of potential to cause long-term damage to lung tissue. RESULTS: Our findings are ordered around a specific model of health seeking devised by adapting previous models. The model and findings span three broad areas that were found to influence health seeking: understandings of health and disease which shaped whether, when and where to seek care; the care seeking decision which was influenced by social and structural factors; and the care seeking experience which impacted future care decisions creating ‘feedback loops’. DISCUSSION: Efforts to improve effective and accessible healthcare provision for chronic lung disease need to address all the determinants of health seeking behaviour identified. This may include: enhancing the structural and financial accessibility of health services, through the strengthening of community linkages; improving communication between formal health providers, patients and communities around symptoms, diagnosis and management of chronic lung diseases; and improving the quality of diagnostic and management services through the strengthening of health systems ‘hardware’ (equipment availability) and ‘software’ (development of trusting and respectful relationships between providers and patients). Public Library of Science 2018-12-17 /pmc/articles/PMC6296555/ /pubmed/30557307 http://dx.doi.org/10.1371/journal.pone.0208188 Text en © 2018 Saleh et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Saleh, Sepeedeh
Bongololo, Grace
Banda, Hastings
Thomson, Rachael
Stenberg, Berthe
Squire, Bertie
Tolhurst, Rachel
Dean, Laura
Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study
title Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study
title_full Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study
title_fullStr Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study
title_full_unstemmed Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study
title_short Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study
title_sort health seeking for chronic lung disease in central malawi: adapting existing models using insights from a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296555/
https://www.ncbi.nlm.nih.gov/pubmed/30557307
http://dx.doi.org/10.1371/journal.pone.0208188
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