Journal of Education and Health Promotion

Exploring Challenges of Access to Non‑Communicable Disease (NCD) Prevention, Treatment and Care: A Qualitative Study on People Living with NCDs (PLWNCDs) in West Bengal, India

Document Type : Original Article

Authors

. Sutapa Biswas
. Debayan Podder 1
. Sweety Suman Jha 2
. Prachi Kathuria 3
. Bobby Paul 4

1 Department of Health and Family Welfare, Government of West Bengal, West Bengal, India

2 Dr. B.C. Roy Multi‑Speciality Medical Research Centre, IIT Kharagpur, West Bengal, India

3 HRIDAY, New Delhi, India

4 Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India

Abstract
BACKGROUND: People living with noncommunicable diseases (PLWNCDs) are often
disproportionately affected due to adverse interaction with socioecological and biological factors.
Hence, it is imperative to learn from their lived experience to gain a greater understanding of
interactions as well as explore their priorities and needs in accessing care and identify areas of
priority action through multistakeholder engagement.
MATERIALS AND METHODS: The qualitative study with grounded theory approach was
conducted between October and December 2020. An online key‑informant interview with the health
policymaker, virtual group discussion with eight PLWNCDs, and in‑depth telephonic interviews
with five PLWNCDs were conducted, after obtaining informed consent using interview guide,
developed, and validated by the experts. Data collection continued till data saturation was achieved.
Transcripts generated from the interview recordings were coded using hand‑code technique and
analyzed thematically.
RESULTS: Challenges faced by PLWNCDs in accessing care were lack of empathy and support
from health‑care professionals, stigma, financial hardship, and hospital overcrowding. Caregivers
emphasized on the felt need to involve civil society organizations (CSOs) in raising awareness toward
noncommunicable diseases (NCDs) at family, community, and policymaking levels. The need for
home‑based NCD care and rehabilitation centers was voiced by the PLWNCDs. Impediments toward
effective implementation of NCD policies were adoption of a “top‑down” approach, poor awareness
about government health insurance schemes, skewed distribution of empanelled hospitals in and
around cities, nonavailability of qualified health‑care professionals in underserved areas, aggravated
allocation‑utilization disparity during COVID‑19 pandemic, and lack of robust information technology
infrastructure to support access to telemedicine services.
CONCLUSION: The collective role of governments, CSOs, and health‑care providers, along with
meaningful involvement of PLWNCDs, would help to create an enabling environment for overcoming
the challenges of access to care and thus achieve universal health coverage.

Keywords

Grounded theory
health services accessibility
India
noncommunicable diseases
qualitative research
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Journal of Education and Health Promotion
Volume 12, Issue 7
August 2022
Pages 1-9

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