Integrating sexual and reproductive health services into existing tuberculosis care: a qualitative study
1
1 Community Medicine, Manikganj Medical College, Manikganj, Bangladesh
2
2 Department of Public Health and Informatics, Bangladesh Medical University, Dhaka, Bangladesh
3
3 Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
Popul. Med. 2026;8(Supplement Supplement 1):A1501
ABSTRACT
INTRODUCTION:
patients with tuberculosis (TB) frequently encounter sexual and reproductive health (SRH) issues due to the disease itself and its associated medication, creating a double burden. in bangladesh, fragmented services across different tiers of the health system have resulted in unmet SRH needs among TB patients. this study aimed to explore the integration of SRH services into existing TB care to enhance comprehensive patient management and improve health outcomes.
METHODS:
this qualitative study, guided by grounded theory, was conducted in dhaka city. participants included adult TB patients from dots centres, health care providers (HCPs) from selected dots centres and hospitals, and stakeholders directly involved in TB-related policy making in bangladesh. purposive sampling was applied to select study sites and participants. data collection involved 14 in-depth interviews (IDIs) with TB patients and 15 key informant interviews (KIIs) with HCPs and stakeholders, supplemented by observation and informal discussions. transcripts were analyzed manually using thematic analysis following braun and clarke.
RESULTS:
five themes emerged through iterative coding: SRH service needs and utilization, psycho-social and cultural dynamics, knowledge, attitude and perception, barriers to access and affordability, and solutions towards TB-SRH integrated services. challenges were identified at patient, community, service, and health system levels in accessing SRH services. participants highlighted multiple opportunities for integration, emphasizing revised guidelines, trained hcps, and strengthened referral linkages as priority interventions.
CONCLUSIONS:
triangulation of findings suggests that integrating SRH services into TB care through dots centres and mhealth platforms, tailored to socio-cultural contexts and cost-effectiveness, could significantly improve SRH outcomes among TB patients. the study underscores the need for policy-level commitment and capacity building to ensure sustainable TB-SRH integrated services in bangladesh.
patients with tuberculosis (TB) frequently encounter sexual and reproductive health (SRH) issues due to the disease itself and its associated medication, creating a double burden. in bangladesh, fragmented services across different tiers of the health system have resulted in unmet SRH needs among TB patients. this study aimed to explore the integration of SRH services into existing TB care to enhance comprehensive patient management and improve health outcomes.
METHODS:
this qualitative study, guided by grounded theory, was conducted in dhaka city. participants included adult TB patients from dots centres, health care providers (HCPs) from selected dots centres and hospitals, and stakeholders directly involved in TB-related policy making in bangladesh. purposive sampling was applied to select study sites and participants. data collection involved 14 in-depth interviews (IDIs) with TB patients and 15 key informant interviews (KIIs) with HCPs and stakeholders, supplemented by observation and informal discussions. transcripts were analyzed manually using thematic analysis following braun and clarke.
RESULTS:
five themes emerged through iterative coding: SRH service needs and utilization, psycho-social and cultural dynamics, knowledge, attitude and perception, barriers to access and affordability, and solutions towards TB-SRH integrated services. challenges were identified at patient, community, service, and health system levels in accessing SRH services. participants highlighted multiple opportunities for integration, emphasizing revised guidelines, trained hcps, and strengthened referral linkages as priority interventions.
CONCLUSIONS:
triangulation of findings suggests that integrating SRH services into TB care through dots centres and mhealth platforms, tailored to socio-cultural contexts and cost-effectiveness, could significantly improve SRH outcomes among TB patients. the study underscores the need for policy-level commitment and capacity building to ensure sustainable TB-SRH integrated services in bangladesh.
| eISSN: | 2654-1459 |
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