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简介：AbstractBackground:Tuberculosis (TB) is a major global health threat and the leading infectious disease cause of death worldwide. Access to and retention in TB care remains a challenge for patients, particularly those living in rural and remote settings. This qualitative study explored barriers and facilitators to accessing and maintaining contact with TB care services in communities in Xigaze (Shigatse) prefecture, Xizang Autonomous Region (Tibet Autonomous Region), China from the perspective of persons impacted by TB.Methods:We conduced in-depth interviews with 23 participants impacted by TB in four rural districts in Xigaze prefecture, Xizang Autonomous Region, China between April 2019 and November 2020. Interviews were conducted in Tibetan and Mandarin, transcribed in Mandarin and translated into English. Transcripts were checked against recordings by native Tibetan and Mandarin speakers. QSR NVivo12 software was used for framework analysis guided by an access to care conceptual framework by Levesque et al.Results:Overall patients reported low awareness of and an indifferent attitude towards TB, although all reported understanding the need to adhere to treatment. Participants reported complex pathways to care, often requiring visits to multiple healthcare facilities. Some participants reported visiting traditional Tibetan medicine (TTM) providers. Participants reported various barriers to accessing care including challenges physically reaching care, out-of-pocket payments for tests, diagnostics and transport. Barriers to maintaining care included medication side effects and worry about treatment effectiveness. Enablers to accessing care identified included knowledge or past experience with TB, integrated models of TTM and western care, supportive village doctors who conducted home visits, free TB treatment and other subsidies, as well as having family support with care and social support as barriers and facilitators to maintaining treatment.Conclusions:We identified barriers and facilitators to accessing services in rural communities in Xigaze from the perspective of persons impacted by TB. Challenges include complex pathways to care, travel distances, wait times and low awareness. Tuberculosis care in the region could be strengthened by ongoing culturally tailored educational campaigns to increase awareness, partnerships with TTM providers, providing comprehensive treatment subsidies and strengthening the role of family members in comprehensive TB care.

简介：在那些之中的服务和它有在一张农村南方印第安人population.METHODSA人口的单方的视觉缺陷(VI)的联系因素基于代表性的学习的眼睛照顾的利用上的AIMTo报告处于AndhraPradesh的状态在三个区域(Adilabad，Mahbubnagar和西方Godavari)被进行，印度。详细会见和全面眼睛考试被进行。那些关于在视觉并且在眼睛照顾服务的利用上注意任何变化与单方的VI被问问题。参加者为不利用服务报导的最重要的原因被用于分析。多重逻辑回归模型被用来检验在在象4456个参加者变老的VI.RESULTSAmong的住处，严厉和原因的年龄，性，教育和区域那样的视觉和socio人口统计的变量注意一个变化之间的协会16y被管理问询表，53.2%是女人，并且54.7%没有教育。489(11%；95%CI：10.1-11.9)有单方的VI的人，399(81.6%)参加者报导了在最后五年在他们的视觉注意一个变化但是仅仅136(34.1%)参加者寻求了眼睛照顾咨询。有任何教育的那些(或：1.9；95%CI：1.1-3.2)，有的盲目(或：2.7；95%CI：1.4-5.2)，并且奔流(或：2.1；95%CI：1.0-4.3)因为单方的VI的一个原因是相似的更多寻求，看照顾咨询。为不寻求眼睛照顾服务的最通常报导的原因是没有钱因为在30.7%参加者的眼睛检查列在后面由没有一个严重问题(30.0%)农村人口的大比例不过注意了的.CONCLUSIONA在他们的视觉的一个变化没寻求眼睛照顾由于金融并且人相关的原因。眼睛照顾服务供应商需要这些障碍到地址与单方的VI在那些之中提高眼睛照顾服务的举起。