Barriers to access and re-attendance for treatment of podoconiosis: a qualitative study in northern Ethiopia

Abstract

This study illustrates the multiple, step-wise barriers to accessing treatment faced by podoconiosis patients. These factors are dynamic, frequently interact and result from competing social and economic priorities.

The impact of leprosy, podoconiosis and lymphatic filariasis on family quality of life: A qualitative study in Northwest Ethiopia

“…Similar findings were found in a study on women with disabilities in Ethiopia, who experienced societal denial of marriage and motherhood [54]. Several studies among persons affected by leprosy, lymphatic filariasis and podoconiosis found high levels of stigma-for example among persons affected by podoconiosis in Ethiopia [17,20,29,52,[55][56][57][58][59]. Some of these studies attributed the high levels of stigma to beliefs about the disease's causation-the belief that podoconiosis is hereditary [55,59].…”

Podoconiosis, trachomatous trichiasis and cataract in northern Ethiopia: A comparative cross sectional study

“…Alongside economic poverty, individuals with podoconiosis are marginalised and stigmatised within their societies, leading to reduced living standards in comparison to their healthy neighbours [ 11 , 14 ]. Marginalisation within society alongside poor living standards among individuals living with podoconiosis may predispose to eye disease and reduced visual acuity through affecting health seeking behaviour [ 43 ], attendance for surgical procedures and disease prevention awareness.…”

Using Qualitative Methods to Explore Lay Explanatory Models, Health-Seeking Behaviours and Self-Care Practices of Podoconiosis Patients in North-West Ethiopia

“…In addition, there are frequent gatherings in the communities surrounding these holy water sites; promoting discussion of IOCC services, especially highlighting how services are free of charge, could engage a large proportion of podoconiosis sufferers. Expert patients have previously been proposed by Tsegay et al as a means to shaping community expectations surrounding treatment,[ 15 ] and could be similarly utilised in community discussions to promote the services, and adherence to such regimes, offered by the IOCC, as well as a novel method to tackle community-based stigma. This could be a very cost-effective solution to expanding access to services and prompt sufferers to engage with IOCC clinics earlier in the course of their disease.…”

“…As reported elsewhere, a further way to engage with lay health beliefs, tackle community stigma and promote access to IOCC services could be through “expert patients”. [ 15 ] This study underlines significant challenges to self-care, especially in collecting adequate water for washing. Expanding access to clean water is of utmost importance for the effective treatment of affected persons.…”

“…Several studies have identified significant barriers to podoconiosis patients’ attendance at IOCC clinics, with major challenges being: geographical isolation, cost, domestic duties and stigma. [ 15 , 16 ] It was hypothesised that additional factors may influence peoples’ health-seeking behaviour, especially early in their illness. Early health-seeking behaviour models were based on pathways to care, in which a stepwise journey starts at identification of symptoms and ends with the use of care.…”