a) Health Policy, Delivery of Health Services & Health Care
AU : Jagota P
TI : Sociological research conducted in the field of tuberculosis in India
SO : STC NEWSLETTER 1999, 9, 5-15
DT : Per
AB :

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 effective.
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.