Health needs and coping strategies of the TB patients in Khyber Pakhtunkhwa, Pakistan : a multidimensional assessment with strategies | |
| Author | Saqib, Shahab E. |
| Call Number | AIT Diss no.RD-19-04 |
| Subject(s) | Tuberculosis--Patients--Pakistan Quality of life--Pakistan |
| Note | A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Regional and Rural Development Planning, School of Environment, Resources and Development |
| Publisher | Asian Institute of Technology |
| Series Statement | Dissertation ; no. RD-19-04 |
| Abstract | Pakistan is one among countries where tuberculosis (TB) is one of the major causes of morbidity and mortality. Due to the heavy presence of TB in Khyber Pakhtunkhwa, the study undertook the task to study the disease in social context. The dissertation has applied the social epidemiological approach to assess and explore the factors associated with family history of TB, social support/needs of the TB patients, delay in treatment, economic burden/needs at the household level, health status and satisfaction level of patients over the available health services. Both primary and secondary data was used in this dissertation. A total of 269 patients were interviewed at the health centres through standardised questionnaires. In-depth interviews, key informant interviews and one focus group discussion were conducted. Descriptive and analytical statistics were employed to analyse the data. The results revealed that patients were mostly young. They were in their productive years of age. Most of the patients were illiterate or had primary level education only. Patients were of low economic status. Significant risk factors associated with TB family history in patients were age, education, structure of house, household size, rooms in houses, room ventilation, monthly income, income sufficiency, food sufficiency, smoking, diabetes and heart disease. The tuberculosis patients experienced an overall lower level of social support from their families, friends and communities and they needed more social support. Low level of the social support led to stigma which further combined with low income, causing high treatment delay. Likewise, lack of awareness about the TB centre and treatment from local traditional healers were important reasons for the treatment delay. Treatment delay due to the lack of social support, low income and poverty. The results showed that TB still costs people a lot, pushing them into poverty. The intensity of catastrophic health expenditures was higher for households in the lower income-quintile. Several coping strategies were practiced among the different income-quintiles. Furthermore, lack of social support and low income caused low health status of the patients due to TB. However, study revealed that a high percentage of patients was satisfied with the DOTS facilities. Available health facilities and high satisfaction of the TB patients show that interventions tackling the socio-economic determinants of TB and the social determinants of successful therapeutic intervention at the individual and community level are very important. Health workers need to be involved in disseminating knowledge about the causes of TB and awareness regarding social support. The doctors should also focus on the psychological problems of the patients. To alleviate poverty, programmes like financial packages may be extended to these patients. The. patients may be provided support from Benazir Income Support Programme from the federal government and Sehat Insaf Cards may be issued from provincial government. Improving the infrastructure facilities at the TB centres, allocation of doctors and nurses at the rural centres will have a positive outcome of the DOTS. This dissertation may help the NTP, and PTP managers working for TB eradication in Pakistan to formulate policies and improve the health services delivery considering the socio- economic determinants now and in future. |
| Year | 2019 |
| Corresponding Series Added Entry | Asian Institute of Technology. Dissertation ; no. RD-19-04 |
| Type | Dissertation |
| School | School of Environment, Resources, and Development (SERD) |
| Department | Department of Development and Sustainability (DDS) |
| Academic Program/FoS | Rural Development, Gender and Resources (RD) |
| Chairperson(s) | Ahmad, Mokbul Morshed; |
| Examination Committee(s) | Routray, Jayant Kumar;Chatterjee, Joyee S.; |
| Scholarship Donor(s) | Higher Education Commission (HEC) Pakistan; |
| Degree | Thesis (Ph. D.) - Asian Institute of Technology, 2019 |