Abstract:
Background
Patients’ health-seeking behaviour can lead to delays in tuberculosis (TB) diagnosis, how-
ever little is known about the experiences and treatment pathways of patients diagnosed
with TB in Kenya. The aim of this study is to explore the health seeking practices and factors
contributing to delay in TB diagnosis.
Methods
This study was based on explorative qualitative research using a constructivist grounded
theory approach. A total of 61 TB patients in the intensive phase of treatment were recruited
as informants in the study. Six focus group discussions and 15 in-depth interviews were
used to collect data. Data were analysed through three step coding using the grounded the-
ory approach.
Results
Participants adopted different treatment pathways as they sought care from a pluralistic
health care system involving traditional healers, herbalists, private clinic, drug shops and
the public health sector. The study revealed an explanatory model of factors leading to
delay illustrated by the participant’s expression “I suffered for a long time.” The model is
comprised of three categories that lead to delays, namely individual, social-cultural and
structural factors.
Conclusion
There is a need to improve timely diagnosis of TB through innovative approaches such as
intensive case finding. Similarly, the health-care system should decentralize TB services as
much as possible and offer free diagnostic services to increase accessibility.