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Gender and key population disparities in tuberculosis programs in Cambodia: a situational assessment of the national response
Siyan Yi
KHANA Center for Population Health Research
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3045-5386
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This work is licensed under a CC BY 4.0 License. Read Full License
Background Globally, the successes in tuberculosis (TB) programs are hampered by the challenges in new case identification, particularly in key and vulnerable populations. Identification of gaps in the programs in response to gender and key population sensitivity is crucial in reaching the un-identified cases. This study aims to define TB key populations, assess gender- and key population-specific issues, and identify successes and gaps in the national TB response in Cambodia.
Methods This national assessment was conducted in 2018 through a consultative workshop and a validation workshop with representatives of multi-stakeholder groups, a desk review of documents from all levels of the national health system, and 19 in-depth interviews and 30 focus group discussions with policymakers, service providers, and representatives of key populations. Content analysis was conducted for qualitative interviews.
Results We identified seven TB key populations to be prioritized for the national TB programs in Cambodia. Key themes that inhibit access to TB services included the lack of knowledge and awareness, distance to TB clinics, lack of time and financial means, and other systemic barriers such as inconsistencies in policy and guideline implementation at different levels of the health system and lack of financial and human resources required for effective program implementation. We did not find any indications of discriminatory practices against women and key populations. In general, community participation in the national TB response was encouraging. However, there were significant gaps in data and reporting system at all levels, which are required to understand the burden of TB and risk behaviors in genders and key populations.
Conclusions Disparities in gender and key populations are well-recognized in Cambodia. Barriers to TB services faced by key populations ought to be addressed through consistent engagements with different stakeholders. Data availability is vital for enhancing the understanding of gender and key population gaps, and the existing data should be duly utilized. Mechanisms to ensure equality and inclusivity are necessary to end TB in Cambodia.
Keywords
Barrier in access to care, high-risk population, service gap, developing country
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This is a preprint. It has not completed peer review.
Research
Gender and key population disparities in tuberculosis programs in Cambodia: a situational assessment of the national response
Siyan Yi
KHANA Center for Population Health Research
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3045-5386
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 09 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Globally, the successes in tuberculosis (TB) programs are hampered by the challenges in new case identification, particularly in key and vulnerable populations. Identification of gaps in the programs in response to gender and key population sensitivity is crucial in reaching the un-identified cases. This study aims to define TB key populations, assess gender- and key population-specific issues, and identify successes and gaps in the national TB response in Cambodia.
Methods This national assessment was conducted in 2018 through a consultative workshop and a validation workshop with representatives of multi-stakeholder groups, a desk review of documents from all levels of the national health system, and 19 in-depth interviews and 30 focus group discussions with policymakers, service providers, and representatives of key populations. Content analysis was conducted for qualitative interviews.
Results We identified seven TB key populations to be prioritized for the national TB programs in Cambodia. Key themes that inhibit access to TB services included the lack of knowledge and awareness, distance to TB clinics, lack of time and financial means, and other systemic barriers such as inconsistencies in policy and guideline implementation at different levels of the health system and lack of financial and human resources required for effective program implementation. We did not find any indications of discriminatory practices against women and key populations. In general, community participation in the national TB response was encouraging. However, there were significant gaps in data and reporting system at all levels, which are required to understand the burden of TB and risk behaviors in genders and key populations.
Conclusions Disparities in gender and key populations are well-recognized in Cambodia. Barriers to TB services faced by key populations ought to be addressed through consistent engagements with different stakeholders. Data availability is vital for enhancing the understanding of gender and key population gaps, and the existing data should be duly utilized. Mechanisms to ensure equality and inclusivity are necessary to end TB in Cambodia.
Figure 1
Figure 2