PubMed · 2004 · 126 citations · 0 references
Public HealthCommunity HealthHealth SciencesHealth EquityTuberculosis ControlWomen's HealthTuberculosis CareTuberculosis DiagnosisTuberculosis EpidemiologyTuberculosis Health EducationTuberculosis PreventionWomen's Health CareAccess To TreatmentCommunity Health Education On TuberculosisSemi-structured InterviewsTraditional Healers' KnowledgeTraditional Healing BeliefsTuberculosis Knowledge AssessmentTuberculosis Stigma Reduction
The study aimed to identify gender‑specific barriers to tuberculosis treatment in The Gambia and to recommend health education and decentralised services to improve access. Researchers conducted semi‑structured interviews with 15 health workers and 15 male and 15 female TB patients, then applied a thematic framework analysis to the qualitative data. Women were more likely to seek traditional healers, experienced greater stigma, and faced similar transport‑cost barriers as men, underscoring that TB remains highly stigmatized and access‑challenging, particularly for women, in The Gambia.
The Medical Research Council unit in Fajara, The Gambia.To explore gender differences in care seeking behaviour, access to treatment, and knowledge and perceptions about tuberculosis.Fifteen government health workers were interviewed to define the scope of the issues involved, then 15 male and 15 female tuberculosis patients were interviewed. Qualitative semi-structured questionnaires were used in health worker and patient interviews. Data were analysed using the thematic framework method. The main themes were compared between male and female patients.Patients often initially consulted traditional healers and pharmacies. Women used traditional healers more, probably because of stronger traditional beliefs, time constraints and increased confidentiality. Regardless of sex, most patients acknowledged problems affording the transport costs to access treatment. Health workers and patients highlighted negative perceptions of tuberculosis. Lack of knowledge about tuberculosis and stigma were widely reported, and were worst in female patients.Tuberculosis is a stigmatised disease in The Gambia, particularly in women, and its management is associated with access problems. Health education is required to provide basic knowledge about the disease and to reduce stigma, and further decentralisation of tuberculosis services is needed to improve access.