Abstract
BackgroundTuberculosis is a serious global health problem. Its paradigms are shifting through time, especially in rapidly developing countries such as China. Health providers in China are at the forefront of the battle against tuberculosis; however, there are few empirical studies on health providers' perspectives on the challenges they face in tuberculosis control at the county level in China. This study was conducted among health providers to explore their experiences with tuberculosis control in order to identify bottlenecks and emerging challenges in controlling tuberculosis in rural China.MethodsA qualitative approach was used. Semi-structured, in-depth interviews were conducted with 17 health providers working in various positions within the health system of one rural county (ZJG) of China. Data were analyzed based on thematic content analysis using MAXQDA 10 qualitative data analysis software.ResultsHealth providers reported several problems in tuberculosis control in ZJG county. Migrant workers and the elderly were repeatedly documented as the main obstacles in effective tuberculosis control in the county. At a personal level, doctors showed their frustration with the lack of new drugs for treating tuberculosis patients, and their opinions varied regarding incentives for referring patients.ConclusionThe results suggest that several problems still remain for controlling tuberculosis in rural China. Tuberculosis control efforts need to make reaching the most vulnerable populations a priority and encourage local health providers to adopt innovative practices in the local context based on national guidelines to achieve the best results. Considerable changes in China's National Tuberculosis Control Program are needed to tackle these emerging challenges faced by health workers at the county level.
Highlights
The countdown to the 2015 deadline for the Millennium Development Goals (MDG) has already begun [1]
‘Health managers’ are the staff involved in the non-clinical aspect of TB control while ‘health providers’ are the staff involved in controlling the clinical aspects of TB
Population Elderly patients were considered an obstacle in TB control by health providers in ZJG county
Summary
The countdown to the 2015 deadline for the Millennium Development Goals (MDG) has already begun [1]. The MDG target to halt and reverse the tuberculosis (TB) epidemic by 2015 has already been achieved [2], the global rate of decline in the incidence of TB is less than 1% per year which makes it impossible to achieve TB elimination by 2050 until the gaps in worldwide TB control are identified and resolved [3,4]. China has made remarkable progress in controlling TB by cutting its prevalence in half, reducing its incidence by 3.4% per year and reducing the TB-induced mortality rate by 80%; with approximately 0.86 million newly notified tuberculosis cases in 2012 [2], China still has the second highest burden of TB after India.
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