| Titre : | Can I afford free treatment ? Perceived consequences of health care provider choices among people with tuberculosis in Ho Chi Minh City, Vietnam. (2001) |
| Auteurs : | Knut LONNROTH ; Vinod DIWAN ; HOANG THI QUY . (.) ; LE MINH THUONG . (.) ; Thuc-Uyen TRAN ; Department of Public Health Sciences. Division of International Health Iiicar Karolinska Institutet. Stockholm. SWE ; Nordic School of Public Health. Göteborg. SWE ; Pham Ngoc Thach Tb and Lung Disease Center. Ho Chi Minh City. VNM |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 52, n° 6, 2001) |
| Pagination : | 935-948 |
| Langues: | Anglais |
| Mots-clés : | Attitude ; Tuberculose ; Bactériose ; Infection ; Malade ; Secteur privé ; Secteur public ; Homme ; Thérapeutique médicamenteuse ; Thérapeutique ; Honoraires ; Politique santé ; Vietnam ; Asie ; Qualité ; Soins |
| Résumé : | [BDSP. Notice produite par INIST xSN3R0xm. Diffusion soumise à autorisation]. Vietnam has a well-organised National TB Control Programme (NTP) with outstanding treatment results. Excellent prospect of cure is provided free of charge. Still, some people prefer to pay for their TB treatment themselves in private clinics. This is a potential threat to TB control since no notification of cases treated in the private sector occurs, and there is no control of the effectiveness of treatment provided in private clinics. Using a qualitative approach within a grounded theory framework, this study explores health-seeking behaviour among people with TB. applying a specific focus on reasons for choices of private versus pubic health care providers. The study identifies a number of characteristics of private TB care, which both seem attractive to patients and at the same time contrast sharply with the structure of the NTP strategy. These include flexible diagnostic procedures, no administrative procedures to establish eligibility for treatment, flexible choices of drug regimens, non-supervised treatment (no DOT), no tracing of defaulters in the household, no official registration of TB cases and thus less threat to personal integrity. A possibility to demand individualised service through the use of fee-for-service payments directly to physicians also seems attractive to many patients. A number of the components of the NTP strategy that have been put in place in order to secure optimal public health outcomes are lacking in the private sector. (...) |
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