UNDERSTANDING THE ACCESS BARRIERS AND ITS CONSEQUENCE TO THE LEPROSY CARE IN NILPHAMARI DISTRICT, BANGLADESH

Karim, Mohammad Monjurul , Prof. dr. Adi Utarini, MSc., MPH., PhD; dr. Ari Probandari, MPH, Ph.D

2020 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Background: Though Bangladesh eliminated leprosy, however, disability rate among newly detected cases are high. Cases remain hidden and often come to the facility after visible Grade 2 Disabilities (G2D). Sufferers are reluctant to reach the facility at the early stage of the disease. It’s important to know the causes and consequences of delaying service to reduce further burden of the disease. Objective: To explore access barriers and its consequence to the leprosy care in a selected endemic district of Bangladesh. Method: This was a qualitative study, conducted through fourteen in-depth interview and two key informants interview in a leprosy endemic district in Bangladesh. Thematic analysis was used to interpret data. Result: Personal experience of the disease along with unacceptance of community were revealed a great barrier to early service seeking. Service availability at the locality and belief about the service played a significant role in decision making to access services. The complex consequences of different stage of the disease pushed the disease into more complexity. Lack of awareness and inappropriate decision making process contributed to delay in service seeking thus increase the number of disability. Conclusion: Awareness rising and appropriate policy focusing resources poor communities are required. Family, community and local service providers need to adhere into the system to ensure early service seeking tendency. More implementation research focusing on implementation barrier to leprosy care is required at this stage. Mass education to combat leprosy is advised to the endemic regions to fight against the leprosy.

Background: Though Bangladesh eliminated leprosy, however, disability rate among newly detected cases are high. Cases remain hidden and often come to the facility after visible Grade 2 Disabilities (G2D). Sufferers are reluctant to reach the facility at the early stage of the disease. It’s important to know the causes and consequences of delaying service to reduce further burden of the disease. Objective: To explore access barriers and its consequence to the leprosy care in a selected endemic district of Bangladesh. Method: This was a qualitative study, conducted through fourteen in-depth interview and two key informants interview in a leprosy endemic district in Bangladesh. Thematic analysis was used to interpret data. Result: Personal experience of the disease along with unacceptance of community were revealed a great barrier to early service seeking. Service availability at the locality and belief about the service played a significant role in decision making to access services. The complex consequences of different stage of the disease pushed the disease into more complexity. Lack of awareness and inappropriate decision making process contributed to delay in service seeking thus increase the number of disability. Conclusion: Awareness rising and appropriate policy focusing resources poor communities are required. Family, community and local service providers need to adhere into the system to ensure early service seeking tendency. More implementation research focusing on implementation barrier to leprosy care is required at this stage. Mass education to combat leprosy is advised to the endemic regions to fight against the leprosy. Background: Though Bangladesh eliminated leprosy, however, disability rate among newly detected cases are high. Cases remain hidden and often come to the facility after visible Grade 2 Disabilities (G2D). Sufferers are reluctant to reach the facility at the early stage of the disease. It’s important to know the causes and consequences of delaying service to reduce further burden of the disease. Objective: To explore access barriers and its consequence to the leprosy care in a selected endemic district of Bangladesh. Method: This was a qualitative study, conducted through fourteen in-depth interview and two key informants interview in a leprosy endemic district in Bangladesh. Thematic analysis was used to interpret data. Result: Personal experience of the disease along with unacceptance of community were revealed a great barrier to early service seeking. Service availability at the locality and belief about the service played a significant role in decision making to access services. The complex consequences of different stage of the disease pushed the disease into more complexity. Lack of awareness and inappropriate decision making process contributed to delay in service seeking thus increase the number of disability. Conclusion: Awareness rising and appropriate policy focusing resources poor communities are required. Family, community and local service providers need to adhere into the system to ensure early service seeking tendency. More implementation research focusing on implementation barrier to leprosy care is required at this stage. Mass education to combat leprosy is advised to the endemic regions to fight against the leprosy

Kata Kunci : Leprosy, Access barrier, Consequence