||Sociological research conducted in the field of tuberculosis
||STC NEWSLETTER 1999, 9, 5-15
The paper presents a comprehensive analysis of
the sociological research on TB conducted in India between 1956-1998.
Human suffering; health seeking behaviour, factors affecting and
improving treatment compliance are the important sociological aspects
of TB that have been investigated. The genesis of DOTS has been
traced to the long-standing efforts to try different strategies
to overcome the problems associated with treatment completion for
e.g., development of supervised, intermittent and SCC regimens.
Following are the salient conclusions given in this paper:
In the early 60s, the visionary approach of researchers
to focus on the sociological and epidemiological aspects of TB ensured
that the NTP, from its inception, was socially relevant and epidemiologically
The level of knowledge of TB does not necessarily lead to patients
seeking relief or taking treatment regularly. It is the physical
suffering which is found to be associated with the action taking.
Cough is found to be one of the most important chest symptoms of
TB as it prompts patients to take action for relief.
Organizational and administrative factors such
as insufficient facilities for management of TB, inadequate and
irregular supply of anti-TB drugs, long distance to travel for seeking
relief, drug intake or drug collection act as barriers and prevent
patients to be adherent for treatment. Training of health providers
is essential so that they give accurate advice to patients concerning
treatment and manage the TB activities. Certain other actions to
improve treatment adherence include decentralization of TB services
while ensuring regular supervision of programme activities.
Increased research efforts in sociological aspects
of TB are needed for successful implementation of DOTS programme.
There is a need to explore the feasibility of including diverse
groups such as private practitioners, social & leprosy workers
and dais (birth attendants), as DOTS supervisor. We can also investigate
the utilization of other agencies like STD booths and pan shops.
The barriers to the expansion of DOTS programme should be removed.
|KEY WORDS: SOCIAL RESEARCH; HEALTH SERVICES; INDIA