Tb Control In Henan Province Sociology Evaluation Studies

1.Research GoalsThrough social assessment, researching the understanding, attitudes, and behaviors to TB (tuberculosis) prevention, control and project strategy, and also the pathway they gained the information about TB among different population groups. Identifying their demand and need, studying all kinds of influencing factors to project, bringing forward and taking corresponding measures to strong the management of DOTS (Directly Observed Treatment of Short Course Strategy), elevating the level of case detection, treatment and management, accelerating the implement of project object.2. Research MethodsCombining qualitative and quantitative research approaches, the quantitative research used non-random sampling to generate data; the qualitative research identified the explanation of results and further analysis. The study was carried out in three counties in Henan, which have low GDP and separate geographically. Two of them have poor quality of DOTS. One is better. Quantitative research used talking questionnaire, surveyed 600 community residents, 210 sufferers, and 210 TB suspects. Using kinds of qualitative research, talking with community residents 12 groups, health providers 6 groups, talking in-depth relative staff in health institution 54 groups, 60 sufferers, and 60 TB suspects. Observing 12 men*days. The whole field survey persisted for 2 months.3. Research ResultsMost target population had heard of TB. But most of them only knew the name of this disease. More than half of target population did not know how TB spreads. Parts of them thought that TB was resulted from inherit. Most of the community residents knew one or two key measure to cure pulmonary tuberculosis (PTB), 17% did not know. More than 80% residentsthought PTB can be cured. In addition, 49. l%of those surveyed did not know there were institutions that specialize in TB treatment situated locally. 72% of the residents had no knowledge that TB treatment was free for smear positive patients. Sufferers and suspects gained the information mainly from doctors (separately 61.8% and 41.5%) theresidents got information mostly from charting.The results from the quantitative study revealed that residents,sufferers and suspects surveyed were firstly concerned about their health . In residents and suspects they secondly worried about the burden of medical cost. In sufferers they secondly worried about transferring the disease to their family. There were no obvious social stigmas related to TB. But the qualitative study results revealed some potential TB related social stigmas, such as less active social lives and difficulties in finding spouses in unmarried people, etc.The expenses TB patients paid counts on 32% of the total expenditure of the family per year. The cost used before diagnose was half more than the treating TB cost after diagnose. This is a heavy burden to a family. The patient who has a better economic condition paid more on TB treatment, but the patient who has a less economic condition had a larger rate (medical cost vs. total expenditure). More than 90% sufferers and suspects went to see doctor timely, but less than half of the sufferers can be diagnosed timely. There was no treatment delay.The survey on the order of seeking care in different family members revealed that in rural China traditional belief was reserved. The male older and boy would receive care firstly. Females were restrained from seeking care.The first choice for the residents for health care was at village level. The main reasons for choosing a medical institution were short travel distances. The PTB patients seek care timely at village level before they were Hiacmnsprl The results from qualitative study indicated that 80%suspects were not transferred to anti-TB institution. The reason was nobody asked them to do so.The PTB patients accepted regularly treatment mostly. There was about 10% patients leave out taking medicine. The main cause was forgot. More than half patients were observed to take medicine during the treatment under the village doctor or the family. According to the necessary of taking medicine under observation most of them thought it was unnecessary, counts on 63%.4. Conclusion:In the poor, remote and underdeveloped regions, a weak economy and low levels of education resulted in poor knowledge and understanding of TB within the poor community. This causes a high incidence of TB and delayed care seeking, diagnosis and transfer of TB cases. All of these caused that the TB patients cannot be detected timely by care seeking. The most disadvantaged group with regard to seeking treatment was women and the elder. Treating TB has a high financial burden in community residents. The expenses TB patients paid counts on 32% of the total expenditure of the family per year. Health care provider should renew their knowledge and diagnosis measure. They should improve their sensitivity on TB. The most important is how to motivate their positivity of detection and transferring TB patients.5. SignificanceIdentified the social factors, which limited the improvement of DOTS quality in poor area. Identified the project influence to relative people. Identified the main obstacle in disadvantaged population to gain TB care. Provided the basis to adjust and perfect the TB control strategy, to improve the justice of health service. Consequently improve the detection rate and cure rate of patient. Suffice furthest different demand and need about TB in different population.