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Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study.

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Saleh, Sepeedeh, Bongololo, Grace, Banda, Hastings, Thomson, Rachael, Stenberg, Berthe, Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038, Tolhurst, Rachel and Dean, Laura ORCID: https://orcid.org/0000-0002-4910-9707 (2018) 'Health seeking for chronic lung disease in central Malawi: Adapting existing models using insights from a qualitative study.'. PLoS ONE, Vol 13, Issue 12, e0208188.

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Abstract

BACKGROUND
Chronic lung diseases contribute to the growing non-communicable disease (NCD) burden and are increasing, particularly in many low and middle-income countries (LMIC) in sub-Saharan African. Early engagement with health systems in chronic lung disease management is critical to maintain quality of life and prevent further damage. Our study sought to understand health seeking behaviour in relation to chronic lung disease and TB in a rural district in Malawi.
METHODS
Qualitative data was collected between March-May 2015, exploring patterns of health seeking for lung disease amongst residents of two districts in rural Malawi. Participants included those with and without lung disease, health workers and village leaders. Participants with a history of TB were included in the sample due to similarities in clinical presentation and in view of potential to cause long-term damage to lung tissue.
RESULTS
Our findings are ordered around a specific model of health seeking devised by adapting previous models. The model and findings span three broad areas that were found to influence health seeking: understandings of health and disease which shaped whether, when and where to seek care; the care seeking decision which was influenced by social and structural factors; and the care seeking experience which impacted future care decisions creating 'feedback loops'.
DISCUSSION
Efforts to improve effective and accessible healthcare provision for chronic lung disease need to address all the determinants of health seeking behaviour identified. This may include: enhancing the structural and financial accessibility of health services, through the strengthening of community linkages; improving communication between formal health providers, patients and communities around symptoms, diagnosis and management of chronic lung diseases; and improving the quality of diagnostic and management services through the strengthening of health systems 'hardware' (equipment availability) and 'software' (development of trusting and respectful relationships between providers and patients).

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis
WF Respiratory System > Tuberculosis > WF 310 Therapy
WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Education
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pone.0208188
Depositing User: Stacy Murtagh
Date Deposited: 18 Dec 2018 12:41
Last Modified: 18 Dec 2018 12:41
URI: http://archive.lstmed.ac.uk/id/eprint/9846

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