NDLI: Lived experiences of tuberculosis patients and their implications for early tuberculosis case identification and management in pastoralist community setting: a qualitative study in Borena zone, Oromia region of Ethiopia

Content Provider	Springer Nature : BioMed Central
Author	Megerso, Abebe Deyessa, Negussie Jarso, Godana Worku, Alemayehu
Abstract	Background Ethiopia has highly diversified population with notable socioeconomic and cultural differences. Regardless of the differences, short course directly observed treatment,where patients should take drugs under direct observasion of health care providers, is uniformly applied all over the country. Evidences are scarce on how well does this uniform approach fits with the pastoral community setting. The purpose of this study was to explore lived experiences of TB patients in the pastoral community under the uniform approach, and their implications to early case identification and management. Method Qualitative method with phenomenological study design was undertaken to explore lived experiences of TB patients. Patients from all levels of health care (hospital, health center and health post) were included. Experience of both drug susceptible and drug resistant TB patients were documented. Twenty one patients, who consented to in the study, were selected by a convenience sampling method. In-depth interview was conducted using a semi-structured interview guide and the interview ended subsequent to information saturation. The interview was audio recorded; and field notes were also taken. Data analysis was done concurrently with the data collection using a word processor designed for qualitative text analysis. InductiveThematic analysis was undertaken to identify key themes. Results Twenty one patients (eight from hospitals, nine from health centers and four from health posts) were interviewed. Three of the eight hospital patients were on drug resistant tuberculosis (TB) treatment. Sixty two codes, five code categories and three themes emerged from the interviews. The three themes were health system, stigma and discrimination, and socioeconomic problem related experiences. Inaccessibility to health facilities due to scattered settlement and mobility, delay in care seeking TB symptoms, low index of suspecting TB by care providers, fear of stigma and indirect treatment related costs were some of the codes identified. Conclusion TB patients in the pastoral setting were experiencing multifaceted challenges with the current application of ‘one-size-fits-all’ approach which implied hampered timely case identification and compromised patient management. Therefore, designing context appropriate intervention approach is required to ensure unprejudiced services.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-020-05787-1.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-020-05787-1
Journal	BMC Health Services Research
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-10-09
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Case detection DOTs Lived experience Pastoral Tuberculosis (TB)
Content Type	Text
Resource Type	Article
Subject	Health Policy

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