ArticleGlobal health action2017
How patients navigate the diagnostic ecosystem in a fragmented health system: a qualitative study from India.
Article in Global health action, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Rapid molecular tests for tuberculosis and tuberculosis drug resistance: a qualitative evidence synthesis of recipient and provider views.The Cochrane database of systematic reviews · 2022Pooled it
- Lessons in quality from the successful recognition and management of schwannomma in a tribal adolescent in rural Rajasthan, India: The pivotal role of plural, porous, and learning primary care teams.Journal of family medicine and primary care · 2026Article
- Point of care devices in primary care setting in india: A scoping review.BMC primary care · 2025Article
- Self-care and health seeking for diabetes and hypertension in Cambodia.Health policy and planning · 2025Article
- Who We Test For: Aligning Relational and Public Health Responsibilities in COVID-19 Testing in Scotland.Medical anthropology · 2024Article
- Respiratory symptoms after TB treatment completion: A qualitative study of patient and provider experiences in urban Blantyre, Malawi.PLOS global public health · 2024Article
- Uncertainty in tuberculosis clinical decision-making: An umbrella review with systematic methods and thematic analysis.PLOS global public health · 2024Article
- Article
- The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam.BMJ global health · 2023Article
- Article
- Do private providers initiate anti-tuberculosis therapy on the basis of chest radiographs? A standardised patient study in urban India.The Lancet regional health. Southeast Asia · 2023Article
- A Strategic Research Framework for Defeating Diabetes in India: A 21st-Century Agenda.Journal of the Indian Institute of Science · 2023Review
- The hidden burden of medical testing: public views and experiences of COVID-19 testing as a social and ethical process.BMC public health · 2022Article
- The potential of digital molecular diagnostics for infectious diseases in sub-Saharan Africa.PLOS digital health · 2022Review
- Can Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation Research from India.Tropical medicine and infectious disease · 2021Article
- Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature.Health services insights · 2021Article
- Aligning diagnostics to the point-of-care: lessons for innovators, evaluators and decision-makers from tuberculosis and HIV.BMJ global health · 2020Article
- The TB REACH Initiative: Supporting TB Elimination Efforts in the Asia-Pacific.Tropical medicine and infectious disease · 2020Article
- Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepending on a country's diagnostic infrastructure, patients and providers play different roles in ensuring that correct and timely diagnosis is made. However, little is known about the work done by patients in accessing diagnostic services and completing the 'test and treat' loop.
objectiveTo address this knowledge gap, we traced the diagnostic journeys of patients with tuberculosis, diabetes, hypertension and typhoid, and examined the work they had to do to arrive at a diagnosis.
methodsThis paper draws on a qualitative study, which included 78 semi-structured interviews and 13 focus group discussions with patients, public and private healthcare providers, community health workers, test manufacturers, laboratory technicians, program managers and policymakers. Data were collected between January and June 2013 in rural and urban Karnataka, South India, as part of a larger project on barriers to point-of-care testing. We reconstructed patient diagnostic processes retrospectively and analyzed emerging themes and patterns.
resultsThe journey to access diagnostic services requires a high level of involvement and immense work from patients and/or their caretakers. This process entails overcoming cost and distance, negotiating social relations, continuously making sense of their illness and diagnosis, producing and transporting samples, dealing with the social consequences of diagnosis, and returning results to the treating provider. The quality and content of interactions with providers were crucial for completion of test and treat loops. If the tasks became overwhelming, patients opted out, delayed being tested, switched providers and/or reverted to self-testing or self-treatment practices.
conclusionOur study demonstrated how difficult it can be for patients to complete diagnostic journeys and how the health system works as far as diagnostics are concerned. If new point-of-care tests are to be implemented successfully, policymakers, program officers and test developers need to find ways to ease patient navigation through diagnostic services.
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