Table 3 Contextual barriers and enablers to tuberculosis care in Xigaze, Xizang
From: A qualitative study of perspectives on access to tuberculosis health services in Xigaze, China
Domain | Barrier | Enabler |
|---|---|---|
Ability to perceive | • Indifferent attitude towards TB • Disbelief about diagnosis | • Knowledge of TB • Past experience with TB |
Ability to seek | • Multiple referrals • Seeking only symptom relief from private TTM doctors | • Integrated public TTM and western care |
Ability to reach | • Symptoms of TB • Limited transport • Wait times for services • Literacy barriers | • Family support to help with transport • Village doctors • Home visits |
Ability to pay | • Shared health insurance scheme amongst family members • Out-of-pocket payment for check-ups, testing supplies (sputum boxes), blood tests and CT scans • Transportation costs including hotel stays • Income lost from travelling for medical care | • Free medicines • Hospitalization coverage • Nutrition subsidies • Financial support from family |
Ability to engage | • Authoritative patient-provider relationship • Less information provided on potential medication side-effects | • Authoritative patient-provider relationship • Village doctors • Lifestyle advice |
Ability to maintain care | • Side effects from medications • Worry about whether medications will be effective | • Improvement in symptoms • Support from family members reminding them to take their medications and connect with healthcare providers |