ArticleBMJ open2021
Improving pathways to care through interventions cocreated with communities: a qualitative investigation of men's barriers to tuberculosis care-seeking in an informal settlement in Blantyre, Malawi.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Gendered experiences of people living with tuberculosis or leprosy: A global systematic review.PLoS neglected tropical diseases · 2026Pooled it
- Drivers of sex differences in Mycobacterium tuberculosis immunoreactivity among adolescents and adults in Blantyre, Malawi.BMC global and public health · 2026Article
- Modelling the impact of increasing tuberculosis treatment coverage and addressing determinants of risk in men.Communications medicine · 2026Article
- Finding the missing men with tuberculosis: a participatory approach to identify priority interventions in Uganda.Health policy and planning · 2025Article
- Exploration of the social determinants of diarrhoea, rotavirus vaccine uptake, and vaccine 'fatigue' in Ethiopia, Kenya, and Malawi.PloS one · 2025Article
- Assessing awareness of latent tuberculosis infection: the urgent need for clinical governance-driven education in rural Eastern Cape - insights from a community-based study.Frontiers in public health · 2025Article
- Using intersectional gender analysis to identify challenges in tuberculosis care at four health care facilities in Uganda.Infectious diseases of poverty · 2024Article
- Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis.European respiratory review : an official journal of the European Respiratory Society · 2023Review
- The impact of time at home on potential yield of home-based TB contact investigation.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Temporal trends in mortality of tuberculosis attributable to high fasting plasma glucose in China from 1990 to 2019: a joinpoint regression and age-period-cohort analysis.Frontiers in public health · 2023Article
- Geospatialization of tuberculosis and income transfer programs among Indigenous peoples in an endemic territory.Revista brasileira de enfermagem · 2022Article
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Authors and funding
9 authors.
Funding
Abstract
introductionMen have a higher prevalence of undiagnosed tuberculosis (TB) than women and can spend up to a year longer contributing to ongoing transmission in the community before receiving treatment. Health outcomes are often worse for patients with TB living in informal settlements especially men. This study aimed to understand the barriers preventing men from seeking care for TB and cocreate interventions to address these barriers.
methodsWe used qualitative research methods including in-depth interviews and participatory workshops. Researchers worked with women and men living in Bangwe, an informal settlement in Blantyre, Malawi to develop interventions that reflected their lived realities. The study took place over two phases, in the first phase we undertook interviews with men and women to explore barrier to care seeking, in the second phase we used participatory workshops to cocreate interventions to address barriers and followed up on issues emerging from the workshops with further interviews. In total, 30 interviews were conducted, and 23 participants joined participatory workshops. The team used a thematic analysis to analyse the data.
resultsThree interconnected thematic areas shaped men's health TB seeking behaviour: precarious socioeconomic conditions; gendered social norms; and constraints in the health system. Insecurity of day labour with no provision for sick leave; pressure to provide for the household and a gendered desire not to appear weak and a severely under-resourced health system all contributed to men delaying care in this context. Identified interventions included improved patient-provider relations within the health-system, improved workers' health rights and broader social support for households.
conclusionImproving mens' pathways to care requires interventions that consider contextual issues by addressing individual level socioeconomic factors but also broader structural factors of gendered social dynamics and health systems environment.
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