Perspective of Patients & Health Care Providers Regarding Responsiveness at Fatima Jinnah Chest hospital, Quetta. A Qualitative Study: Patients & Health Care Responsiveness at Fatima Jinnah Chest Hospital, Quetta.

Sher Afgan  Raisani; Humaira  Mahmood; Jawaria  Khan; Zafar  Iqbal; Yaser  Mahmood; Shahnoor  Zia; Shahkoh  Mengal; Tehseen  Rafaqat; Irfan Ahmed  Raisani; Shaista  Zulfiqar

doi:10.54393/pjhs.v4i03.607

Authors

Sher Afgan Raisani TB Control Program, Quetta, Pakistan
Humaira Mahmood Department of Public Health, Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan
Jawaria Khan Department of Public Health, Armed Forces Post Graduate Medical Institute, Rawalpindi, Pakistan
Zafar Iqbal TB Control Program, Quetta, Pakistan
Yaser Mahmood Dental Department, Cantt General Hospital, Rawalpindi, Pakistan
Shahnoor Zia Dental Department, Sandeman Hospital, Quetta, Pakistan
Shahkoh Mengal Health Department, Quetta, Pakistan
Tehseen Rafaqat Dental Department, HBS Medical College, Islamabad, Pakistan
Irfan Ahmed Raisani TB Control Program, Quetta, Pakistan
Shaista Zulfiqar Department of Community Medicine, Fauji Foundation Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i03.607

Keywords:

Healthcare provider; Responsiveness; Tuberculosis

Abstract

Tuberculosis is highly contagious with an estimated global incidence of 10 million in 2018. Pakistan has the world’s 5^th highest Tuberculosis burden. Achieving adequate responsiveness remains an elusive challenge for Pakistan's health system. Many factors regarding eight dimensions of the health system responsiveness are leading to a huge number of missing cases, loss to follow up and treatment failure and thus burden of the disease is increasing significantly. Objectives: To explore the perspective of health care providers and patients regarding the responsiveness. Methods: A qualitative study was conducted in Fatima Jinnah Chest Hospital, Quetta from February 2021 to July 2021. Two Focus Group Discussions comprising of 8-12 Health Care Providers of Fatima Jinnah Chest Hospital were conducted. Non- Probability purposive sampling was employed. Thematic Analysis was done. Results: Advance technology, communication barrier, basic facilities, and patient overflow were four overlapping themes that emerged from focus group discussion of health care providers. Conclusions: Overall results and findings indicate that there is a need for investment in both material and structured improvements at Fatima Jinnah Chest Hospital and improvement of services at primary level to reduce burden at tertiary care hospital like Fatima Jinnah.

References

Jamison DT, Alwan A, Mock CN, Nugent R, Watkins D, Adeyi O, et al. Universal Health Coverage and Intersectoral Action for Health: Key Messages from Disease Control Priorities. The Lancet. 2018 Mar; 391(10125): 1108-20. doi: 10.1596/978-1-4648-0524-0.

González-Duran JA, Plaza RV, Luna L, Arbeláez MP, Deviaene M, Keynan Y, et al. Delayed HIV treatment, barriers in access to care and mortality in tuberculosis/HIV co-infected patients in Cali, Colombia. Colombia Médica. 2021 Oct; 52(4): e2024875.

Murray CJ, Ortblad KF, Guinovart C, Lim SS, Wolock TM, Roberts DA, et al. Global, Regional, and National Incidence and Mortality for HIV, Tuberculosis, and Malaria during 1990–2013: a Systematic Analysis for the Global Burden of Disease Study 2013. The Lancet. 2014 Sep; 384(9947): 1005-70.

Khan RA, Shaikh AA, Bulaadi GQ. Incidence of Multidrug-Resistant Tuberculosis in Sindh, Pakistan. Cureus. 2019 Apr; 11(4). doi: 10.7759/cureus.4571

World Health Organization. WHO Factsheet: Tuberculosis. 2020.

Available at: https://www.who.int/news-room/fact-sheets/detail/tuberculosis.

Ullah W, Wali A, Haq MU, Yaqoob A, Fatima R, Khan GM. Public–private Mix Models of Tuberculosis Care in Pakistan: a High-Burden Country Perspective. Frontiers in Public Health. 2021 Aug; 9: 703631. doi: 10.3389/fpubh.2021.703631

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and Regional Mortality from 235 Causes of Death for 20 Age Groups in 1990 and 2010: a Systematic Analysis for the Global Burden of Disease Study 2010. The lancet. 2012 Dec; 380(9859): 2095-128.

Khan RA, Shaikh AA, Bulaadi GQ. Incidence of Multidrug-Resistant Tuberculosis in Sindh, Pakistan. Cureus. 2019 Apr; 11(4). doi 10.7759/cureus.4571

Akhtar AM, Arif MA, Kanwal S, Majeed S. Prevalence and Drug Resistance Pattern of MDR TB in Retreatment Cases of Punjab, Pakistan. J Pak Med Assoc. 2016 Aug; 66(8): 989-3.

UNITED NATIONS. Sustainable Development Goals: 2019. Available at: https://unfoundation.org/what-we-do/issues/sustainable-development goals/?gclid=CjwKCAiAr4GgBhBFEiwAgwORrZ48HhMez5zbI6tYK-6RCEeM8DUu1oFV63ibkmo0HztgCDUu-PGoZxoCrFYQAvD_BwE

Chakaya J, Castro JL, Jensen PM, Fujiwara PI. A New Era for Global Tuberculosis: Holding Leaders Accountable for Promises. The International Journal of Tuberculosis and Lung Disease. 2018 Dec; 22(12): 1387. doi: 10.18356/6a0e015b-en

World Health Organization. World Health Report: 2001. Available at :https://www.who.int/teams/global-tuberculosis-programme/tb-report

Ugurluoglu O, Celik Y. How responsive Turkish Health Care System is to its Citizens: the Views of Hospital Managers. Journal of Medical Systems. 2006 Dec; 30: 421-8.doi: 10.1007/s10916-005-9006-8

Fazaeli S, Hashemi SA, Ebrahimipour H, Banikazemi SH, Yousefi M. Importance of Health System Responsiveness in a High and Low Income Areas in Mashhad, Iran: A Household Survey. Payesh (Health Monitor). 2016 Apr; 15(2): 153-62.

Chao J, Lu B, Zhang H, Zhu L, Jin H, Liu P. Healthcare System Responsiveness in Jiangsu Province, China. BMC Health Services Research. 2017 Dec; 17: 1-7. doi: 10.1186/s12913-017-1980-2

Kapologwe NA, Kibusi SM, Borghi J, Gwajima DO, Kalolo A. Assessing Health System Responsiveness in Primary Health Care Facilities in Tanzania. BMC Health Services Research. 2020 Dec; 20(1): 1-0. doi: 10.1186/s12913-020-4961-9

Tille F, Röttger J, Gibis B, Busse R, Kuhlmey A, Schnitzer S. Patients’ Perceptions of Health System Responsiveness in Ambulatory Care in Germany. Patient Education and Counseling. 2019 Jan; 102(1): 162-71. doi: 10.1016/j.pec.2018.08.020

Daneshkohan A, Zarei E, Ahmadi-Kashkoli S. Health System Responsiveness: A Comparison between Public and Private Hospitals in Iran. International Journal of Healthcare Management. 2020 Dec; 13(sup1): 296-301. doi: 10.1080/20479700.2018.1540183.

Stewart Williams J, Myléus A, Chatterji S, Valentine N. Health Systems Responsiveness among Older Adults: Findings from the World Health Organization Study on global AGEing and adult health. Glob Public Health. 2020 Jul; 15(7): 999-1015. doi: 10.1080/17441692.2020.1742365. Epub 2020 Mar 23. PMID: 32200690.

Najafi F, Karami-Matin B, Rezaei S, Rajabi-Gilan N, Soofi M. Health System Responsiveness after Health Sector Evolution Plan (HSEP): An Inpatient Survey in Kermanshah in 2015. Medical Journal of the Islamic Republic of Iran. 2016; 30: 387