Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso

Laokri, Samia; Drabo, Maxime; Weil, Olivier; Kafando, Benoît; Dembelé, Sary Mathurin; Dujardin, Bruno

doi:10.1371/journal.pone.0056752

Cited by 41 publications

(42 citation statements)

References 15 publications

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“…However, several possible definitions of “catastrophic costs” were discussed in the reviewed papers, including “>10% of monthly household income” [52], “>10% of annual household income” [61, 74]; “>40% of non-subsistence household income” [5, 44]; or “using non-reversible coping strategies” [29]. …”

Section: Discussionmentioning

confidence: 99%

Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review

et al. 2014

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In order to inform the development of appropriate strategies to improve financial risk protection, we conducted a systematic literature review of the financial burden of tuberculosis (TB) faced by patients and affected families.The mean total costs ranged from $55 to $8198, with an unweighted average of $847. On average, 20% (range 0–62%) of the total cost was due to direct medical costs, 20% (0–84%) to direct non-medical costs, and 60% (16–94%) to income loss. Half of the total cost was incurred before TB treatment. On average, the total cost was equivalent to 58% (range 5–306%) of reported annual individual and 39% (4–148%) of reported household income. Cost as percentage of income was particularly high among poor people and those with multidrug-resistant TB. Commonly reported coping mechanisms included taking a loan and selling household items.The total cost of TB for patients can be catastrophic. Income loss often constitutes the largest financial risk for patients. Apart from ensuring that healthcare services are fairly financed and delivered in a way that minimises direct and indirect costs, there is a need to ensure that TB patients and affected families receive appropriate income replacement and other social protection interventions.

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Section: Discussionmentioning

confidence: 99%

Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review

et al. 2014

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“…A review of the detection and reporting system should be done by focusing on the increase of laboratories and qualified professionals as well as a double registration of cases that guarantees the validity of information beyond the modernization of the means of records. This will allow the provincial level to have immediate access to information, which requires the use of internet and other modern technological means in all health units (22) . From the speeches of MS12 and NPS14 on the way information circulates, it signals a controlling discourse invested with a dominant and evaluative paradigm, thus suggesting that the information provided is linked to the obligation and not necessarily to compliance with the norms (17) .…”

Section: Discussionmentioning

confidence: 99%

Obstacles in the detection and reporting of tuberculosis cases: a discursive analysis

et al. 2018

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Objective: To analyze the discourses of health professionals about the obstacles in the process of detection and reporting of tuberculosis cases in Mozambique. Method: Qualitative exploratory study with a theoretical-methodological approach of Discourse Analysis of French matrix. The study was conducted in Mozambique in 2014 at three levels: central, provincial and district. The study included 15 health professionals, 4 physicians, 6 technicians and 5 nursing professionals, who worked in the National Tuberculosis Control Program, with more than 1 year of experience. Result: The following discursive blocks emerged: Detection of tuberculosis cases in laboratories; Underreporting of tuberculosis cases; Obstacles to detect cases of tuberculosis: long distances and lack of transport; and Reporting of cases for decision making. Final considerations: The discourses analyzed point to the ideological affi liation that includes the lack of investment policies in the health sector and the political commitment as basic obstacles in the detection and reporting of tuberculosis cases. Descriptors: Tuberculosis; Social Policy; Health Policy; Health Service; Nursing in Public Health. RESUMO Objetivo: Analisar os discursos dos profi ssionais de saúde acerca das barreiras no processo de detecção e notifi cação dos casos de tuberculose em Moçambique. Método: Estudo exploratório qualitativo com abordagem teórico-metodológica da Análise de Discurso de matriz francesa. O estudo foi realizado em Moçambique, no ano de 2014, em três níveis: central, provincial e distrital. Fizeram parte do estudo 15 profi ssionais de saúde, sendo 4 médicos, 6 técnicos e 5 profi ssionais de enfermagem, que atuavam no Programa Nacional de Controle da Tuberculose, com mais de 1 ano de experiência. Resultado: Emergiram os seguintes blocos discursivos: Detecção dos casos da tuberculose em laboratórios; Subnotifi cação dos casos da tuberculose; Barreiras para detecção de casos de tuberculose: longas distâncias e falta de transporte; e Notifi cação dos casos para a tomada de decisão. Considerações fi nais: Os discursos analisados apontam para a fi liação ideológica que compreende a falta de políticas de investimento no setor da saúde e do comprometimento político como barreiras basilares na detecção e notifi cação dos casos da tuberculose.

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“…The linguistic marks "patients live far away"; "patients have transportation problems" evidence one of the factors that contribute to the lack of adherence to treatment. Indirectly, discursive sequences may also indicate low monitoring, because patients have difficulties to go to the healthcare unit to be observed, but they can also produce meanings that TB treatment in these conditions entails monetary costs for patients (22) .…”

Section: Discussionmentioning

confidence: 99%

Discursos sobre a terapia de curta duração para o controle da tuberculose

et al. 2017

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Objective: to analyze the meanings produced through the experiences and perceptions of healthcare professionals on the implementation of the strategy of directly observed treatment short course for tuberculosis control. Method: qualitative study carried out in Mozambique with 15 healthcare professionals. Inclusion criteriawerehaving acted in the Tuberculosis Control Program for more than one year, and exercising professional activity at the time of interview. A semi-structured script was used for data collection, and individual interviews were recorded. Results: three discursive units emerged: patient treatment procedures; community health agent and family roles; diffi culties in the application of directly observed treatment short course. Conclusion: treatment of tuberculosis requires constant involvement of the family, community, and especially the State in the creation and implementation of personnel training policies and infrastructure improvement. Descriptors: Nursing Care; Community Health Nursing; Public Health Nursing; Tuberculosis; Public Policies. RESUMO Objetivo: analisar os sentidos produzidos por meio das experiências e percepções dos profi ssionais de saúde sobre a implementação da estratégia do tratamento diretamente observado de curta duração para o controle da tuberculose. Método: estudo qualitativo realizado em Moçambique com 15 profi ssionais de saúde. Critérios de inclusão: atuação no Programa de Controle da Tuberculose há mais de um ano e estar em atividade profi ssional no período da entrevista. Para a coleta de dados foi usado um roteiro semiestruturado e as entrevistas realizadas individualmente foram gravadas. Resultados: emergiram três unidades discursivas: os procedimentos no tratamento do doente; o papel de Agente Comunitário da Saúde e da família; as difi culdades na aplicação do tratamento diretamente observado de curta duração. Conclusão: o tratamento da tuberculose requer um envolvimento constante da família, da comunidade e principalmente do Estado na criação e aplicação de políticas de formação dos recursos humanos e melhoria de infraestruturas. Descritores: Cuidados de Enfermagem; Enfermagem em Saúde Comunitária; Enfermagem em Saúde Pública; Tuberculose; Políticas Públicas. RESUMENObjetivo: analizar los sentidos generados a partir de experiencias y visiones de profesionales de salud sobre la implementación de la estrategia del tratamiento directamente observado de corta duración para el control de la tuberculosis. Método: estudio cualitativo realizado en Mozambique con 15 profesionales de salud. Criterios de inclusión: actuación en Programa de Control de la Tuberculosis mayor a un año y estar activo profesionalmente durante el período de la entrevista. Datos recolectados utilizando rutina semiestructurada; las entrevistas individuales fueron grabadas. Resultados: surgieron tres unidades discursivas: procedimientos en el tratamiento del enfermo; papel del Agente Comunitario de Salud y de la familia; difi cultades en aplicación del tratamiento directamente observado de c...

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Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso

Cited by 41 publications

References 15 publications

Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review

Financial burden for tuberculosis patients in low- and middle-income countries: a systematic review

Obstacles in the detection and reporting of tuberculosis cases: a discursive analysis

Discursos sobre a terapia de curta duração para o controle da tuberculose

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