An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa

Simple item page
dc.contributor.advisorCleary, Susanen_ZA
dc.contributor.authorDocrat, Sumaiyahen_ZA
dc.date.accessioned2014-12-28T14:42:06Z
dc.date.available2014-12-28T14:42:06Z
dc.date.issued2012en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractThe control of tuberculosis (TB) in South Africa has fallen short of the targets outlined by the World Health Organization and without improvement; TB is expected to have grave consequences for both the mortality and morbidity of South Africans as well as crippling financial consequences for the public health system. While services in the public sector are free at the point of use, little is known about overall access barriers and their implications for treatment adherence. This paper explores these barriers from the perspective of TB patients enrolled in Directly Observed Treatment, Short-Course (DOTS) in Mitchell's Plain, South Africa. Using a comprehensive framework of access, in-depth interviews were conducted with 334 TB patients across five facilities in Mitchell's Plain, to assess barriers across the dimensions of availability, affordability and acceptability. Summary statistics were computed and comparisons of access barriers between adherent and non-adherent groups, and between socioeconomic groups were explored using bivariate, multivariate linear and logistic regressions. Among the respondents, 244 (73.05%) met the criteria for adherence (i.e. reported that they had never missed a dose of TB medication) while 90 (26.95%) met the criteria for non-adherence. Marital status, age, birth province, costs of self-care and costs of other providers were found to be significantly associated with adherence (P-values <0.05). There was no significant evidence of inequalities in access by socioeconomic status (all P-values > 0.05). Nonetheless, the results revealed that the poor face increased costs of accessing TB-services, compared to the rich, though this association was not deemed to be significant.en_ZA
dc.identifier.apacitationDocrat, S. (2012). <i>An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/10337en_ZA
dc.identifier.chicagocitationDocrat, Sumaiyah. <i>"An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2012. http://hdl.handle.net/11427/10337en_ZA
dc.identifier.citationDocrat, S. 2012. An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Docrat, Sumaiyah AB - The control of tuberculosis (TB) in South Africa has fallen short of the targets outlined by the World Health Organization and without improvement; TB is expected to have grave consequences for both the mortality and morbidity of South Africans as well as crippling financial consequences for the public health system. While services in the public sector are free at the point of use, little is known about overall access barriers and their implications for treatment adherence. This paper explores these barriers from the perspective of TB patients enrolled in Directly Observed Treatment, Short-Course (DOTS) in Mitchell's Plain, South Africa. Using a comprehensive framework of access, in-depth interviews were conducted with 334 TB patients across five facilities in Mitchell's Plain, to assess barriers across the dimensions of availability, affordability and acceptability. Summary statistics were computed and comparisons of access barriers between adherent and non-adherent groups, and between socioeconomic groups were explored using bivariate, multivariate linear and logistic regressions. Among the respondents, 244 (73.05%) met the criteria for adherence (i.e. reported that they had never missed a dose of TB medication) while 90 (26.95%) met the criteria for non-adherence. Marital status, age, birth province, costs of self-care and costs of other providers were found to be significantly associated with adherence (P-values <0.05). There was no significant evidence of inequalities in access by socioeconomic status (all P-values > 0.05). Nonetheless, the results revealed that the poor face increased costs of accessing TB-services, compared to the rich, though this association was not deemed to be significant. DA - 2012 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa TI - An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa UR - http://hdl.handle.net/11427/10337 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/10337
dc.identifier.vancouvercitationDocrat S. An analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africa. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2012 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/10337en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherHealth Economicsen_ZA
dc.titleAn analysis of adherence & equity in access to TB services in Mitchell's Plain, South Africaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
thesis_hsf_2012_docrat_s (1).pdf
Size:
8.75 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters