Why do patients with a cough delay seeking care at Lusaka urban health centres? A health systems research approach.

摘要: SETTING: Primary health centres in urban Lusaka, Zambia. OBJECTIVES: To describe the distribution and risk factors for delay among patients presenting with a cough to centres. DESIGN: A systems research methodology was used. participatory workshop analysed problem designed cross-sectional survey of attending two Initial data analyses were performed second workshop, results discussed broad range policy-makers, care staff community members interested tuberculosis. RESULTS: total 427 interviewed; 35% had delayed more than one month. Delay associated older age, severe underlying illness, poor perception services, distance from clinic prior attendance at private clinic. There no relationship between knowledge about tuberculosis, nor education, socio-economic level or gender. Tuberculosis HIV felt be closely linked highly stigmatised, but stigmatising attitudes not longer delays. CONCLUSIONS: The an effective way engage district services action-oriented research. Investing improvements system ensuring accessibility disabled is likely reduce delays diagnosis help improve tuberculosis control Lusaka.