Title:
Factors that influence services utilization, case detection and treatment delays among tuberculosis patients in Maputo-Mozambique
Authors:
Sulemane, Nordino Ibraimo
Year:
2016
PAGE:
xi, 42
Language:
En
Subject:
Laboratory Quality Strengthening
Keywords:
Tuberculosis, case detection, services utilization, Maputo-Mozambique, treatment Delay.
Abstract:
Background-Tuberculosis is a disease of public health importance in Maputo, and remains one of the leading causes of morbidity and mortality in the general population, despite increased control efforts. Among the most vulnerable groups, young people and adults standout between 15 to 49 years of age, children under five and people living with HIV and AIDS. Objective- Explore factors that influence services utilization, detection and treatment delays among tuberculosis patients in Maputo, aiming to formulate recommendations and to respond to the constraints and challenges identified. Methodology- for development of this paper, literature review was used, published and unpublished reports and discussions with medical staff from the field and those involved in TB programmes in Maputo. A conceptual framework related to health seeking behaviour adapted from Rundi and Piot models. Results- Findings shows that from provider’s side there is a lack of skilled and motivated staff to diagnose and treat TB. Open hours, services not friendly, lack of confidentiality, stock outs, gaps (distance) between clinicians and patients. Communication barriers between health professionals, TB patients and community in the health units are the factors influencing patients mistrusting the public health services. From the user’s side, patients have many other priorities than health due to poverty. The main aim is to survive each day for food and shelter for them and children. Lack and costs of transport, local cultural perceptions, lack of knowledge about TB, are detrimental. Power relation to decide when and how to use health services for women, are the leading causes for people not using health services to be detected and treated on time. Conclusion-The combinations of factors are detrimental for people when deciding to use the public health services. All the factors make the situation of patients, when ill or onset symptoms of TB, worsen. Inefficiency of health systems, and services provision is the most important factor for people not using the public health services. These, will lead to using the services that offer better conditions and are more accessible to them, such as traditional healers, church leaders, private clinics and drug sellers for self-medication. Recommendations-Consultations and health messages have to be patient focused and based on the individual patient’s needs. The interaction between health professionals has to be as horizontal as possible. The local health policies have to focus on the local specific issues, regarding each population location and beliefs. Above all, political commitment is the key to make all the interventions feasible and practical.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institue)
Department:
Health & Education
Country:
Mozambique
Region:
East Africa
Training:
Master of Public Health/International Course in Health Development (MPH/ICHD)
Category:
research
Right:
© 2016 Sulemane
Document type:
Thesis/dissertation
File:
JNNMNfIjG0_20170507134808138.pdf