Background:
Non-communicable diseases (NCDs) are a clear threat to human health and economic development of a country. Conditions, such as hypertension and chronic obstructive pulmonary disease (COPD), are two leading causes of deaths worldwide. This study assessed the consequences of these conditions on daily functions and healthcare- seeking behaviours of patients and the responses of healthcare providers to the needs of patients in low-income settings.
Methods:
A cross-sectional descriptive study was conducted in one rural and one urban surveillance areas of Bangladesh. Patients of hypertension, COPD, and comorbidity identified in a preceding study phase were interviewed at home using a structured questionnaire to obtain information on the consequences of diseases on household livelihoods, healthcare-seeking behaviours, and coping strategies. Qualitative techniques were used for identifying key factors relating to health-seeking behaviours and for exploring in-depth responses of providers.
Results: COPD, hypertension, and comorbidity lowered the activities of daily living (ADL) scores. The odds ratio (OR) of ADL interruptions for comorbidity (OR: 3.04, p<0.05) was significantly higher compared to hypertension. Financial crises were reported by significantly higher number of patients suffering from COPD in the urban area than in the rural area (12.5% vs. 2.4%, p<0.01). Self-treatment during the initial stage of conditions was common among the patients. Seeking care from trained providers was higher in the urban setting and was higher for hypertension. The referral mechanism for COPD and hypertension patients was inadequate, and referral was rather absent in many cases until the severity of diseases increased.
Conclusions:
The COPD and hypertension significantly impacted ADL and COPD impacted financial situation. Due to lack of standaredized program, the health systems in the study area are yet to ready to respond to the needs of patients with hypertension and COPD. Strengthening primary healthcare facilities with control and prevention strategies are the potential mechanisms to readiness the systems. Research to assess the effectiveness of such programs is essential before proceeding for their large-scale implementation.