Delays in Services Utilization and Treatment for TB patients in Maputo

Nordino I. Sulemane, MPH: Studied International Public Health at Royal Tropical Institute in The Netherlands. With specialization in Health Systems Management. Champions 8 years of experience in Public Healthcare in HIV and TB/MDR with Doctors Without Borders. Intern in Problem Based Learning, at Superior Institute of Health of Rome, Italy.

The aim of this work, is to explore factors that influence services utilization, detection and treatment delays among tuberculosis patients in Maputo, from users and providers side. Systematic literature review was used, published and unpublished reports accessed. Additionally, discussions with medical staff from the field and those involved in TB programmes in Maputo. A conceptual framework related to health seeking behaviour, was adapted from Rundi and Piot models. The study found that from provider's side, there is lack of skilled and motivated staff to diagnose and treat TB. Poor distribution of health professionals with ratios of 51.4/100.000 in the rural area and 168,8/100.000 in urban area. Open hours, services not friendly, lack of confidentiality, stock outs and communication barriers. This combination of factors, is detrimental for people when have to decide to use the public health services. Inefficiency of health system, and services provision, is the most important factor for people mistrusting the public health services.