Health care seeking behaviour of tuberculosis patients in Obunga slums, Kisumu

Abstract

This study was designed to investigate the health care seeking behaviour of TB patients in Obunga slums in Kisumu district. Field work for the study was conducted in the health care facilities located in Obunga slums and the surrounding area. The study sought to describe the perceptions of TB and their influence on health care seeking behaviour, document the health care options available to TB patients and examine factors that influence health care seeking behaviour of TB patients. A total of 100 respondents were sampled using convenient sampling technique. Data collection methods that were used in the study included the survey, focus group discussions and key l:nformal1t interviews. Three focus group discussions were conducted comprising of TB patients (2 groups) and TB ambassadors (J group). The findings indicated that all the patients had some idea about TB before being diagnosed but none thought that they could be suffering from TB. TB was identified by its symptoms mainly persistent cough and chest pains. The patients also associated their condition to other causal factors like cold, smoking, heredity and hard work. A few participants mentioned bacterial infection, indicating that they were not aware of the real causes ofT13. Cultural beliefs about 1'13 treatment were held by most patients. The findings revealed that patients tended to use different therapeutic options [or the same illness based on their perception of what they were suffering from. Most or the patients preferred to self treat at home using both modern and herbal remedies with the hope that the illness would go away easily. With the persistence of the symptoms other therapeutic specialists were consulted, including herbalists, traditional healers, public and private clinics. The health facility was visited when everything else had failed to work, due to the pressure put on the patient by family members. After being diagnosed with "1'13 at the health facility very few patients reported consulting other specialists for help. Various factors were found to influence the patients therapeutic choice, including perceived seriousness of the illness, perceived causes of the illness, distance to the health facility, costs to be incurred, length o.f time taken, long queues at the health facilities, stigmatization of TB patients, and religious sects which restricted their adherents to spiritual healing. It is recommended that members of the public should be sensitized to create awareness on the symptoms, mode of transmission and treatment of T13. This should be done using a medium that is accessible to all members of the public. The government should also fund diagnostic services offered to TB patients especially for chest x-ray so that patients who are smear negative can access this service at no cost. There is also need to equip health facilities with TB testing kits so that patients can get help easily and quickly, to prevent cases of misdiagnosis.