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Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us
INTRODUCTION: The Indian Tuberculosis (TB) Programme currently faces the dual challenges of tackling increasing numbers of drug resistant (DR) TB cases and regulating practices of a pluralistic private sector catering to TB patients. A study of health seeking behaviour of DR-TB patients in such a si...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336307/ https://www.ncbi.nlm.nih.gov/pubmed/30653523 http://dx.doi.org/10.1371/journal.pone.0209924 |
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author | Bhattacharya Chakravarty, Aruna Rangan, Sheela Dholakia, Yatin Rai, Sonu Kamble, Swaran Raste, Tejaswi Shah, Sanchi Shah, Shimoni Mistry, Nerges |
author_facet | Bhattacharya Chakravarty, Aruna Rangan, Sheela Dholakia, Yatin Rai, Sonu Kamble, Swaran Raste, Tejaswi Shah, Sanchi Shah, Shimoni Mistry, Nerges |
author_sort | Bhattacharya Chakravarty, Aruna |
collection | PubMed |
description | INTRODUCTION: The Indian Tuberculosis (TB) Programme currently faces the dual challenges of tackling increasing numbers of drug resistant (DR) TB cases and regulating practices of a pluralistic private sector catering to TB patients. A study of health seeking behaviour of DR-TB patients in such a situation, offers an opportunity to understand the problems patients face while interacting with health systems. METHODOLOGY: Forty-six DR-TB patients drawn from 15 high TB burden wards in Mumbai were interviewed using an open ended interview tool. Interviews were audio recorded and transcribed. Pathway schematics developed from analysis of patient records, were linked to transcripts. Open coding was used to analyse these units and themes were derived after collating the codes. RESULTS AND DISCUSSION: The paper presents themes interwoven with narratives in the discussions. These include awareness-action gap among patients, role of neighbourhood providers, responsiveness of health systems, the not-such a ‘merry go round’ that patients go/are made to go on while seeking care, costs of diagnostics and treatment, and how DR-TB is viewed as the ‘big TB’. CONCLUSION: The recommendations are based on a preventative ethos which is sustainable, compared to interventions with top-down approaches, which get piloted, but fail to sustain impact when scaled up. |
format | Online Article Text |
id | pubmed-6336307 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-63363072019-01-30 Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us Bhattacharya Chakravarty, Aruna Rangan, Sheela Dholakia, Yatin Rai, Sonu Kamble, Swaran Raste, Tejaswi Shah, Sanchi Shah, Shimoni Mistry, Nerges PLoS One Research Article INTRODUCTION: The Indian Tuberculosis (TB) Programme currently faces the dual challenges of tackling increasing numbers of drug resistant (DR) TB cases and regulating practices of a pluralistic private sector catering to TB patients. A study of health seeking behaviour of DR-TB patients in such a situation, offers an opportunity to understand the problems patients face while interacting with health systems. METHODOLOGY: Forty-six DR-TB patients drawn from 15 high TB burden wards in Mumbai were interviewed using an open ended interview tool. Interviews were audio recorded and transcribed. Pathway schematics developed from analysis of patient records, were linked to transcripts. Open coding was used to analyse these units and themes were derived after collating the codes. RESULTS AND DISCUSSION: The paper presents themes interwoven with narratives in the discussions. These include awareness-action gap among patients, role of neighbourhood providers, responsiveness of health systems, the not-such a ‘merry go round’ that patients go/are made to go on while seeking care, costs of diagnostics and treatment, and how DR-TB is viewed as the ‘big TB’. CONCLUSION: The recommendations are based on a preventative ethos which is sustainable, compared to interventions with top-down approaches, which get piloted, but fail to sustain impact when scaled up. Public Library of Science 2019-01-17 /pmc/articles/PMC6336307/ /pubmed/30653523 http://dx.doi.org/10.1371/journal.pone.0209924 Text en © 2019 Bhattacharya Chakravarty 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 Bhattacharya Chakravarty, Aruna Rangan, Sheela Dholakia, Yatin Rai, Sonu Kamble, Swaran Raste, Tejaswi Shah, Sanchi Shah, Shimoni Mistry, Nerges Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us |
title | Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us |
title_full | Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us |
title_fullStr | Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us |
title_full_unstemmed | Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us |
title_short | Such a long journey: What health seeking pathways of patients with drug resistant tuberculosis in Mumbai tell us |
title_sort | such a long journey: what health seeking pathways of patients with drug resistant tuberculosis in mumbai tell us |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336307/ https://www.ncbi.nlm.nih.gov/pubmed/30653523 http://dx.doi.org/10.1371/journal.pone.0209924 |
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