ABSTRACT
BACKGROUND: The government of India is committed to eliminating tuberculosis (TB) by 2025 under the National Tuberculosis Elimination Programme which provides free investigations and treatment as well as incentives for nutritional support during their treatment course. Many TB patients prefer to seek treatment from the private sector which sometimes leads to financial constraints for the patients. Our study aims to find the burden of TB patients in the private sector and the expenses borne by them for their treatment. METHODOLOGY: Sales data of rifampicin-containing formulation drug consumption in the private sector of six districts of Jharkhand was collected from Clearing and Forwarding agencies. Based on the drug sales data, the total incurring costs of the drugs, total number of patients, and cost per patient seeking treatment from the private sector were calculated for the year 2015-2021. ANOVA and the post hoc test (Tukey honestly significant difference (HSD)) were applied for analysis. RESULTS: There was a marked difference amongst all the districts in relation to all the variables namely total costs, cost per patient, and total private patients seeking treatment from the private sector which was statistically significant (p < 0.001). East Singhbhum had the highest out-of-pocket expense and private patients as compared to all six districts. Lohardaga showed the sharpest decline in total private patients from 2015 to 2021. The average cost borne by private patients in 2015 was INR 1821 (95% CI 1086 - 2556) which decreased to INR 1033 (95% CI 507 - 1559) in 2021. CONCLUSION: From the study, it was concluded that the purchase of medicines for TB treatment from the private sector is one of the essential elements in out-of-pocket expenditure (OOPE) borne by TB patients. Hence, newer initiatives should be explored to foresee the future OOPE borne by the patients and decrease OOPE-induced poverty.
ABSTRACT
BACKGROUND: As the number of cases of COVID19 from novel corona virus 2019 rises so are the number of deaths ensuing from it. Doctors have been in front in these calamitous times across the world. India has less number of doctors so doctors are overwhelmed with more number of patients to cater. Thereby they are also fearing that they will be exposed much as they often work in limited resource settings. METHODS: An on line survey was to include doctors from eastern states in India for measuring the reasons of their fear and suggest possible solutions based on the results achieved thus. After IEC clearance a semi-structured anonymous questionnaire was sent on google forms as links on known to doctors, working in screening OPDs or flu clinics especially for COVID-19. RESULTS: Out of 59 Doctors majority were provided with sanitizers for practicing hand hygiene. Gloves were provided everywhere but masks particularly N95 and Triple Layer surgical masks were not there for all. Training was not given universally. Fear was dependent on age in our sample. CONCLUSION: Training and strict adherence to infection control measures along with resources can help in removing the fear.
