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In an ideal world, for every 100 infected people, all 100 would:
Seek timely care
Go to a DOTS facility either directly through referral
Be correctly diagnosed
Begin treatment
Persist with treatment for more than 2 months
Complete treatment
These are the six steps that form the basic structure of the
pathway
Lack of medicines
Lack of DOTS facilities - trouble (time, money)
to attend
Providers fail to give adequate information
about length of treatment, importance of
persistence, side effects
Poor quality of services (e.g., non-supportive
or abusive providers)
Overview of Presentation
Chart out the data and let it guide the decision making
process
Group
Stigma
System
Distance to DOTS provider
No or weak links between non-DOTS and DOTS providers;
non-referral
How to examine reasons
Use both qualitative and quantitative research
Examples of some questions relevant to individual
and group-level barriers for Step 2:
Where should someone go to find out if she or he has TB?
How much does it cost to be tested?
Can TB be cured?
How much does it cost?
How long does it take?
How would your family and neighbors react if they knew
that you went to a DOTS clinic?
Step 3. Decide which barrier(s) to address
these come from the BEHAVE model; many other models exist: NCI Pink
Book, P-Process, Combi, CDCynergy, )
Thank you