Beyond patient delay, navigating structural health system barriers to timely care and treatment in a high burden TB setting in Papua New Guinea

Bibliographic Data

ID15541165
AuthorsPaula Jops (0000-0002-7916-0124, UNSW Sydney, corresponding author), John Cowan (0000-0002-8680-8531, Papua New Guinea Institute of Medical Research), Martha Kupul (0000-0002-0937-1057, Papua New Guinea Institute of Medical Research), Richard Naketrumb (0000-0002-0733-6426, Papua New Guinea Institute of Medical Research), Stephen M Graham (0000-0003-3525-2294, Burnet Institute), M Bauri (0000-0002-1944-5865), Herolyn Nindil (National Department of Health), Stephen Bell (0000-0003-2877-9231, The University of Queensland), Tess Keam (Burnet Institute), Majumdar (0000-0002-9656-557X, Burnet Institute), William Pomat (0000-0003-2640-9640, UNSW Sydney), Benjamin Marais (0000-0003-3404-2690, The University of Sydney), Guy B Marks (0000-0002-8976-8053, Woolcock Institute of Medical Research), John Kaldor (0000-0002-7639-4355, UNSW Sydney), Andrew J Vallely (0000-0003-1558-4822, UNSW Sydney), Angela Kelly-Hanku (0000-0003-0152-2954, UNSW Sydney)
Year2023
Volume18
Issue1
Pages2184482-2184482
Publication date2023-01-02
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueGlobal Public Health (JOURNAL)
Journal identifiersISSN: 1744-1692 • E-ISSN: 1744-1706
PublisherTaylor & Francis (PUBLISHER • GB)
DOI10.1080/17441692.2023.2184482
PMID36883701
OpenAlexW4323533835
LanguageEN
Citations received5
References cited41

Tuberculosis (TB) is a major public health issue in Papua New Guinea, with incidence rates particularly high in the South Fly District of Western Province. We present three case studies, along with additional vignettes, that were derived from interviews and focus groups carried out between July 2019 and July 2020 of people living in rural areas of the remote South Fly District depicting their challenges accessing timely TB diagnosis and care; most services within the district are only offered offshore on Daru Island. The findings detail that rather than 'patient delay' attributed to poor health seeking behaviours and inadequate knowledge of TB symptoms, many people were actively trying to navigate structural barriers hindering access to and utilisation of limited local TB services. The findings highlight a fragile and fragmented health system, a lack of attention given to primary health services, and undue financial burdens placed on people living in rural and remote areas associated with costly transportation to access functioning health services. We conclude that a person-centred and effective decentralised model of TB care as outlined in health policies is imperative for equitable access to essential health care services in Papua New Guinea

Business · Economic growth · Environmental health · Focus group · Health care · New guinea · Public health · Rural area · Rural health · Sociology · Tuberculosis · Global Health and Surgery · Global Maternal and Child Health · Medicine · Nursing · Tuberculosis Research and Epidemiology