Experiences of Tuberculosis in a Tarai Village, Nepal

Ulla-Britt Engelbrektsson, M. Subedi
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Abstract

In focus is the experience of being a Tuberculosis (TB) patient in the mid-west Tarai of rural Nepal. The information derives from a longitudinal qualitative study between 2005 to 2017 in one and the same community. The findings show few changes in the experience of being a TB patient. The availability of anti-TB medicine free of cost within the government health services was greatly appreciated. The cause of TB, ways and means of transmissions, and the need for preventive measures, however, were not well understood. In the case of Child-TB, the expectation of numerous visits to the government treatment centre for the picking up of medicines was a strong deterrant. In consequence, most child-TB cases were diagnosed and treated within the private sector. The distribution system of the medicines, particularly within the government system, clearly added to the burden of being a TB patient and much would have been gained had the arrangement been more patient-friendly, a difference which most likely had also resulted in more children being treated within the public services rather than within the money-geared private sector. Various misunderstandings about the cause/s of the disease need to be addressed. And, much would be gained was the central directive of “patient support”, truly implemented and was a true “two-way communication” to take place.
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尼泊尔塔莱村的肺结核经历
重点是尼泊尔中西部农村Tarai的肺结核患者的经历。这些信息来源于2005年至2017年在同一社区进行的纵向定性研究。研究结果显示,结核病患者的经历几乎没有变化。政府卫生服务部门免费提供抗结核病药物,这一点得到了极大的赞赏。然而,人们对结核病的病因、传播方式和手段以及预防措施的必要性还不太了解。就儿童结核病而言,期望多次前往政府治疗中心取药是一个强有力的威慑因素。因此,大多数儿童结核病病例都是在私营部门内诊断和治疗的。药品的分配系统,特别是在政府系统内,显然增加了结核病患者的负担,如果这种安排对患者更友好,本可以获得很多好处,这种差异很可能也会导致更多的儿童在公共服务部门接受治疗,而不是在以资金为导向的私营部门接受治疗。对这种疾病病因的各种误解需要加以解决。而且,如果“患者支持”的中心指令得到真正实施,这将是一种真正的“双向沟通”。
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30 weeks
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