Using intersectional gender analysis to identify challenges in tuberculosis care at four health care facilities in Uganda.

IF 8.1 1区 医学 Infectious Diseases of Poverty Pub Date : 2024-01-05 DOI:10.1186/s40249-023-01171-3
Winters Muttamba, Samson Omongot, Irene Najjingo, Roseline Nuwarinda, Esther Buregyeya, Mariam Otmani Del Barrio, Rosemary Morgan, Bruce Kirenga, Sarah Ssali
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Abstract

Background: Tuberculosis (TB) care could be considered as a continuum from symptom recognition, decision to seek care, diagnosis, treatment initiation and treatment completion, with care along the continuum influenced by several factors. Gender dimensions could influence TB care, and indeed, more men than women are diagnosed with TB each year. The study was done to identify social stratifiers that intersect with gender to influence TB care.

Methods: A cross-sectional qualitative study was done at four health facilities in 3 districts in central Uganda between October 2020 and December 2020. Data was collected from patients seeking a diagnosis or on TB treatment through focus group discussions and key informant interviews. Key themes around gender guided by a gender and intersectionality lens were developed and thereafter thematic content analysis was done.

Results: Women have increased vulnerability to TB due to bio mass exposure through roles like cooking. Women have increased access to health care services as they interface with the health care system frequently given their role as child bearers and child care givers. Men have a duty to provide for their families and this most often is prioritised over healthcare seeking, and together with belief that they are powerful beings leads to poor healthcare seeking habits and delays in healthcare seeking. Decisions on when and where to seek care were not straightforward for women, who most often rely on their husbands/partners to make decisions.

Conclusions: Men and women experience challenges to TB care, and that these challenges are deeply rooted in roles assigned to them and further compounded by masculinity. These challenges need to be addressed through intersectional gender responsive interventions if TB control is to be improved.

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利用性别交叉分析,确定乌干达四家医疗机构在结核病护理方面面临的挑战。
背景:结核病(TB)治疗可被视为从症状识别、决定就医、诊断、开始治疗到完成治疗的一个连续过程,而这一连续过程中的治疗受多种因素的影响。性别因素可能会影响结核病护理,事实上,每年被诊断为结核病的男性多于女性。本研究旨在确定与性别交叉影响结核病护理的社会分层因素:2020 年 10 月至 2020 年 12 月期间,在乌干达中部 3 个地区的 4 家医疗机构开展了一项横断面定性研究。通过焦点小组讨论和关键信息提供者访谈,从寻求诊断或接受结核病治疗的患者那里收集数据。在性别和交叉性视角的指导下,围绕性别制定了关键主题,随后进行了主题内容分析:结果:由于从事烹饪等工作而接触大量生物,妇女更容易感染结核病。妇女作为孩子的养育者和照顾孩子的人,经常与医疗保健系统打交道,因此她们获得医疗保健服务的机会更多。男性有责任养家糊口,这往往比寻求医疗保健服务更重要,再加上他们认为自己是强大的生命,导致了不良的就医习惯和就医延误。对于妇女来说,何时何地就医并不是一个简单的决定,她们通常要依靠丈夫/伴侣来做决定:结论:男性和女性在结核病护理方面都面临挑战,这些挑战深深植根于赋予他们的角色,并因男性气质而进一步加剧。如果要改善结核病控制,就需要通过跨部门的促进性别平等干预措施来应对这些挑战。
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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty INFECTIOUS DISEASES-
自引率
1.20%
发文量
368
期刊介绍: Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.
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