Barriers of Treatment-Supporters for DOTS under RNTCP in District Shahdol, India: A Mix-Method Study

Authors

  • Rajesh Pandey Chief Medical and Health Officer, Shahdol Madhya Pradesh, India 484001. Author
  • Akash Ranjan Singh Assistant Professor, Department of Community Medicine, Government Medical College Shahdol, Madhya Pradesh, India 484001 Author
  • Vikrant Kabirpanti Associate Professor, Department of Community Medicine, Government Medical College Shahdol, Madhya Pradesh, India 484001 Author
  • Rajesh Mishra District TB Officer, district Shahdol, Madhya Pradesh, India 484001 Author

DOI:

https://doi.org/10.21276/r5tedd38

Keywords:

DOT provider, KAP study, treatment supporter, Operational Research, Mixed-method study

Abstract

Background: One of the challenges of Revised National Tuberculosis Control Programme (RNTCP) has been that it has not been able to impart adequate knowledge, satisfactory attitude and desirable practices among treatment-supporters of rural and tribal communities. Present study was planned to explore the knowledge, attitude, practice and perceived barriers related to Directly Observed treatment (DOT) provision among the treatment-supporters of Shahdol district, Madhya Pradesh in 2018. Methods: Mixed–methods study design of triangulation type was used among 30 community- based treatment-supporters of DOT from Sohagpur tahsil of district Shahdol of Madhya Pradesh, India. The cross-sectional quantitative component assessed the knowledge, attitude and practices and three focus-group discussions were used to explore the perceived barriers related to DOT provision. Results: ‘Adequate knowledge’ related to DOT provision was found in 37% of treatment- supporters, while 40% had “satisfactory attitude” and 60 % had “satisfactory practice” related to DOT. The focus-group discussions revealed, ineffective training, lack of supportive supervision, insecure monetary incentive, distant Public Health Institution/Designated Microscopic Center, language barrier and patient related stigma to TB disease as main perceive challenges related to DOT.

Conclusion: Study revealed inadequate knowledge and unsatisfactory attitude and practice related to DOT provision among treatment-supporters. Effective training, making services accessible to patient, making RNTCP form in Hindi language and strengthening of honorarium disbursement mechanism are urgently required.

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References

Revised National Tuberculosis Control Programme. Technical and Operational Guidelines for the Tuberculosis Control In India 2016 [Internet]. Central TB Division, Directorate General of Health Services, Ministry of Health & Family Welfare, New Delhi, India. 2017 [cited 2017 Aug 17]. Available from: http://tbcindia.gov.in/showfile.php?lid=3197

World Health Organization (WHO). Global Tuberculosis Report 2018 [Internet]. Geneva; 2018 [cited 2018 Nov 1]. Available from: http://apps.who.int/bookorders.

Office of Commissioner & Registrar General of the India. Census of India 2011 MADHYA PRADESH: DISTRICT CENSUS HANDBOOK SHAHDOL [Internet]. 2016 [cited 2018 Jul 14]. Available from: http://censusindia.gov.in/2011census/dchb/2343_PART_B_DCHB_SHAH DOL.pdf

Division CTB. TB India 2013:: Ministry of Health and Family Welfare [Internet]. Revised National Tuberculosis Programme. 2014. Available from: http://www.tbcindia.nic.in/showfile.php?lid=3163

Central TB Division. NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS ELIMINATION 2017–2025 [Internet]. New Delhi: Central TB Division, Directorate General of Health Services, Ministry of Health with Family Welfare, Nirman Bhavan, New Delhi–110108; 2017 [cited 2017 May 2]. 110-108 p. Available from: http://tbcindia.gov.in/WriteReadData/NSP Draft 20.02.2017 1.pdf

Fiseha D, Demissie M. Assessment of Directly Observed Therapy (DOT) following tuberculosis regimen change in Addis Ababa, Ethiopia: a qualitative study. BMC Infect Dis. 2015;15:405.

Kironde S, Bajunirwe F. Lay workers in directly observed treatment (DOT) programmes for tuberculosis in high burden settings: Should they be paid? A review of behavioural perspectives. Afr Heal Sci. 2002;2(2):73–8.

Arcêncio RA, Oliveira MF, Cardozo-Gonzales RI, Ruffino-Netto A, Pinto IC, Villa TCS. City tuberculosis control coordinators’ perspectives of patient adherence to DOT in São Paulo State, Brazil, 2005. Int J Tuberc Lung Dis. 2008;12(5):527–31.

Singh AR, Pakhare A, Kokane AM, Shewade HD, Chauhan A, Singh A, et al. ‘Before reaching the last mile’- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: A mixed method study. J Epidemiol Glob Health [Internet]. 2017 Dec 1 [cited 2018 Dec 14];7(4):219–25. Available from: https://www.sciencedirect.com/science/article/pii/S2210600617301843

Kamineni VV, Wilson N, Das A, Satyanarayana S, Chadha S, Singh Sachdeva K, et al. Addressing poverty through disease control programmes: examples from Tuberculosis control in India. [cited 2017 Jun 28]; Available from: https://equityhealthj.biomedcentral.com/track/pdf/10.1186/1475-9276-11- 17?site=equityhealthj.biomedcentral.com

Office of Commissioner & Registrar General of the India. Population Census 2011: Shahdol district [Internet]. 2016 [cited 2018 Jul 14]. Available from: https://www.census2011.co.in/census/district/327- shahdol.html

National Rural Health Mission. ASHA module 6: Skills that save lives. New Delhi: National Rural Health Mission; 2005.

Creswell Plano clark V J. Designing and conducting mixed methods research. London (United Kingdom): Sage Publications Ltd; 2007.

ONA Systems: Make Data Count Reliable mobile data collection. Accessible visualization. Seamless collaboration [Internet]. Vol. 2017. 2017 [cited 2017 Jun 5]. Available from: https://ona.io/

Baiardi JM, Gultekin L, Brush BL. Using Sociograms to Enhance Power and Voice in Focus Groups. Public Health Nurs. 2015;

SinghAR,PakhareA,KokaneAM,ShewadeHD,ChauhanA,SinghA,et al. Before reaching the last mile- Knowledge, attitude, practice and perceived barriers related to tuberculosis directly observed therapy among ASHA workers in Central India: mixed method study. 2017 [cited 2017 Aug

; Available from: http://ac.els-cdn.com/S2210600617301843/1-s2.0- S2210600617301843-main.pdf?_tid=52794b9c-8321-11e7-a857- 00000aacb362&acdnat=1502956660_01552799e767eb762f31e849e578 e5bf

von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7.

Saldana J. The Coding Manual for Qualitative Research. Los Angeles: Sage Publication; 2010.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Heal Care. 2007;19(6):349–57.

Subbaraman R, Nathavitharana RR, Satyanarayana S, Pai M, Thomas BE, Chadha VK, et al. The Tuberculosis Cascade of Care in India’s Public Sector: A Systematic Review and Meta-analysis. Murray M, editor. PLOS Med [Internet]. 2016 Oct 25 [cited 2018 Dec 14];13(10):e1002149. Available from: https://dx.plos.org/10.1371/journal.pmed.1002149

Singh AR, Pakhare A, Chauhan A, Singh A. Some interesting observations regarding TB patient management from a rural area of Madhya Pradesh: TB case series. J Fam Med Prim care. 2015;4(4):591–3.

State-wise progress under NRHM (National Rural Health Mission) Status as on 31.12.2014 [Internet]. New Delhi: National Health Mission, Ministry of Health & Family Welfare, Government of India; 2015. p. 5–12, 17–9. Available from: http://nrhm.gov.in/images/pdf/mis-report/Dec-2014/1- NRHM.pdf

Pandey R, Singh AR, Kabirpanthi V, Bose, K. Shubhash Chandra Diwedi J, Mishra R. Challenges perceived by the private practitioners in TB notification at district Shahdol, Madhya Pradesh: A mixed-method study. Glob J Res Anal. 2018;7(11):1–4.

Hoffman J a, Cunningham JR, Suleh AJ, Sundsmo A, Dekker D, Vago F, et al. Mobile direct observation treatment for tuberculosis patients: a technical feasibility pilot using mobile phones in Nairobi, Kenya. Am J Prev Med [Internet]. 2010;39(1):91–2. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20537846

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Heal Care. 2007;19(6):349–57.

Singh AR, Pakhare A, Chauhan A, Singh A. Some interesting observations regarding TB patient management from a rural area of Madhya Pradesh: TB case series. J Fam Med Prim care. 2015;4(4):591–3.

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Published

26.03.2024

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Section

ORIGINAL ARTICLES ~ Pharmacology

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