What Constitutes Healthcare-seeking Pathway of TB Patients: A Qualitative Study in Rural Bangladesh

Given the targeted 4–5% annual reduction of tuberculosis (TB) cure cases to reach the “End TB Strategy” by 2020 milestone globally set by WHO, exploration of TB health-seeking behaviour is warranted for insightful understanding. This qualitative study aims to provide an account of the social, cultural, and socioeconomic breadth of TB cases in Bangladesh. We carried out a total of 32 in-depth interviews (IDIs) and 16 key informant interviews (KIIs) in both rural and urban areas of Bangladesh. We covered both BRAC and non-BRAC TB program coverage areas to get an insight. We used a purposive sampling strategy and initially followed the “snowball sampling technique” to identify TB patients. Neuman’s three-phase coding system was adopted to analyze the qualitative data. Underestimation of TB knowledge and lack of awareness among the TB patients along with the opinions from their family members played key roles in their TB health-seeking behaviour. Quick decision on the treatment issue was observed once the diagnosis was confirmed; however, difficulties were in accepting the diseases. Nevertheless, individual beliefs, intrinsic ideologies, financial abilities, and cultural and social beliefs on TB were closely interconnected with the “social perception” of TB that eventually influenced the care-seeking pathways of TB patients in various ways. Individual- and community-level public health interventions could increase early diagnosis; therefore, reduce recurrent TB.

Authors: Shatil, Tanvir; Khan, Nusrat; Yunus, Fakir Md; Chowdhury, Anita Sharif; Reza, Saifur; Islam, Shayla; Islam, Akramul; Rahman, Mahfuzar
Type: Journal Article
Year: 2019