SOCIO-CULTURAL FACTORS INFLUENCING DELAYS IN TUBERCULOSIS TREATMENT-SEEKING AMONG AFGHAN MIGRANTS IN RAWALPINDI, PAKISTAN

Abstract

Tuberculosis (TB) is one of the key public health issues in Pakistan, especially in migrant populations who face numerous obstacles to access healthcare in time. Although free TB services are available, the fact that people take long before seeking treatment still sabotages the process of controlling the disease. The qualitative case study is focused on the socio-cultural and structural issues of delayed TB treatment seeking among Afghan migrants living in Rawalpindi District, Pakistan. The research was conducted based on the in-depth and semi-structured interviews of fourteen Afghan migrants and examined based on the thematic analysis with references to the complex theoretical framework that was based on the Health Belief Model, Social Determinants of Health, and Gender and Migration Theory. The findings suggest that the delays to treatment seeking are caused by multiple factors, such as displacement-related instability, insufficient knowledge of TB signs and services, stigma fears, gender-based mobility and decision-making limitations, and language barriers in the healthcare facility. The factors affect the recognition of symptoms, its disclosure, and access to formal care, which causes long delays. The paper points to the fact that TB treatment-seeking delays among Afghan migrants are socially entrenched phenomena due to structural vulnerability, but not to individual decisions, which implies the necessity of culturally competent, gender responsive, and migrant inclusive TB intervention.