Factors Contributing to the High Default Rate Of the Dots System in the Yendi District

Abstract

This study was designed to elicit the factors that contributed to the high default rate of the DOTs system in the Yendi district. Questionnaires were administered to all patients who registered for DOTs in 1998. 1999 and 2000. Focus group discussions were also conducted to explore the underlying factors for the health seeking behaviors of the people. In-depth interviews were conducted with service providers so as to elicit the service related factors of default alongside the patient related factors of default. Case control study done for these patients showed vividly that lack of knowledge, long distances between home and clinic, poor family support, adverse effects of anti-TB drugs, long duration of treatment, Geographical inaccessibility and poor attitude of service providers were the contributing factors to default. In - depth interviews done elicited poor managerial control of drugs distribution and poor attitude of service providers as contributing factors of default Focus group discussions done showed that lack of knowledge was the main factor contributing to default in the communities. Results of the study call for a more holistic and better managerial approach towards the DOTs system. There is the need for the DHMT to undertake major IEC campaign to create awareness and reduce the myths and misconceptions that people have about TB in the general population. Schools, Churches, Mosques and open durbars may be good places to start educational campaigns in the district. The local dagbani name for Tuberculosis is itself a misconception to the true meaning of Tuberculosis and educational campaigns must also be geared towards this direction.