Health-seeking behavior and barriers to tuberculosis diagnosis and treatment in rural Gurugram, India: A mixed-methods study

BackgroundThe public health problem of tuberculosis (TB) in India worsens because of extended time needed for diagnosis and treatment initiation which affects rural areas most. The National TB Elimination Program (NTEP) requires information about patient healthcare search patterns and their barriers to access in order to achieve its goals. ObjectiveThe research studied rural Gurugram Haryana medical care usage patterns and TB diagnosis and treatment barriers and enablers through patient and healthcare provider feedback collection. The research employed a mixed-methods cross-sectional design to study 201 TB patients who enrolled on the Nikshay Portal between November 2021 and October 2022 at CHC Farukhnagar. The research team conducted data analysis of semi-structured interview data through univariate and multivariate regression methods using STATA SE software. The research team conducted five focused group discussions (FGDs) across villages to analyze qualitative data through NVivo software for thematic analysis. ResultsThe participants average age reached 35 years while their standard deviation reached 15.3 years. The study participants included 56.7% people who were 35 years old or younger and 53.2% of the participants were male. The study found that 58.2% of participants showed good health-seeking behavior which depended on their knowledge that TB is infectious (OR 2.78, 95% CI 1.39-5.54, p=0.003) and their decision to visit health facilities after home remedies failed (OR 13.07, 95% CI 6.63-25.7, p<0.001). The study found that patients faced three main obstacles to receive proper diagnosis which included delayed medical evaluation and financial constraints and insufficient knowledge about smoking-related TB risks. The qualitative research results showed that patients faced three main barriers because of social discrimination and insufficient assistance and their preference for seeking medical care at private facilities. ConclusionThe improvement of health-seeking behavior depends on TB transmission education and public healthcare facility accessibility and reduced patient expenses and better access to public healthcare facilities. The research data enables NTEP to create successful plans which will help eliminate TB from rural Indian communities by 2025.