“我正饱受食物匮乏之苦”：南非开普敦结核病患者及其家庭的粮食不安全状况与社会保护获取情况
"I'm suffering for food": Food insecurity and access to social protection for TB patients and their households in Cape Town, South Africa.
作者信息
Vanleeuw Lieve, Zembe-Mkabile Wanga, Atkins Salla
机构信息
Health Systems Research unit, South African Medical Research Council, Tygerberg, South Africa.
New Social Research and Global Health and Development, Faculty of Social Sciences, Tampere University, Tampere, Finland.
出版信息
PLoS One. 2022 Apr 26;17(4):e0266356. doi: 10.1371/journal.pone.0266356. eCollection 2022.
BACKGROUND
Tuberculosis (TB) is a major health concern and the number one cause of death in South Africa. Social protection programmes can strengthen the resilience of TB patients, their families and households. This study aimed to get a better understanding of the role of social protection and other forms of support in relation to the burden of TB on patients and their households in South Africa.
METHODS
This is a cross-sectional exploratory qualitative study using a phenomenological approach to focus on the lived experiences and perceptions of TB patients and healthcare workers. We interviewed 16 patients and six healthcare workers and analysed data thematically.
RESULTS
The challenges faced by participants were closely related to household challenges. Participants reported a heavy physical burden, aggravated by a lack of nutritious food and that households could not provide the food they needed. Some needed to resort to charity. At the same time, households were significantly affected by the burden of caring for the patient-and remained the main source of financial, emotional and physical support. Participants reported challenges and costs associated with the application process and high levels of discretion by the assessing doctor allowing doctors' opinions and beliefs to influence their assessment.
CONCLUSION
Access to adequate nutritious food was a key issue for many patients and this need strained already stretched households and budgets. Few participants reported obtaining state social protection support during their illness, but many reported challenges and high costs of trying to access it. Further research should be conducted on support mechanisms and interventions for TB patients, but also their households, including food support, social protection and contact tracing. In deciding eligibility for grants, the situation of the household should be considered in addition to the individual patient.
背景
结核病是南非主要的健康问题，也是导致死亡的首要原因。社会保护计划可以增强结核病患者及其家庭的复原力。本研究旨在更好地了解社会保护及其他形式的支持在南非结核病患者及其家庭负担方面所起的作用。
方法
这是一项横断面探索性定性研究，采用现象学方法聚焦于结核病患者和医护人员的生活经历及看法。我们采访了16名患者和6名医护人员，并对数据进行了主题分析。
结果
参与者面临的挑战与家庭挑战密切相关。参与者报告称身体负担沉重，缺乏营养食物使情况更加恶化，且家庭无法提供他们所需的食物。一些人需要求助于慈善机构。与此同时，家庭受到照顾患者负担的显著影响，并且仍然是经济、情感和身体支持的主要来源。参与者报告了申请过程中的挑战和费用，以及评估医生的高度自由裁量权，这使得医生的意见和信念影响了他们的评估。
结论
获得充足的营养食物对许多患者来说是一个关键问题，这种需求使本就捉襟见肘的家庭和预算更加紧张。很少有参与者报告在患病期间获得国家社会保护支持，但许多人报告了申请支持时面临的挑战和高昂费用。应针对结核病患者及其家庭的支持机制和干预措施开展进一步研究，包括食物支持、社会保护和接触者追踪。在决定补助金资格时，除了患者个人情况外，还应考虑家庭状况。
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