Concordance and Discordance of Orthopedicians with Revised National Tuberculosis Control Program with Reference to Musculoskeletal Tuberculosis: A Qualitative Inquiry

• Published in: Indian journal of orthopaedics Vol. 54; no. 5; pp. 711 - 719
• Main Authors: Nagar, Manoj, Joshi, Ankur, Sahu, Saurabh, Nagar, Vivek, Mitra, Arun
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.09.2020
• Subjects: Conservative Orthopedics; Medicine; Medicine & Public Health; Original; Original Article; Orthopedics; Surgical Orthopedics; Bone and joint tuberculosis; Orthopedic surgeon; Revised National Tuberculosis Control Program; Musculoskeletal tuberculosis; Qualitative inquiry
• ISSN: 0019-5413; 1998-3727
• DOI: 10.1007/s43465-020-00068-9

Background Musculoskeletal tuberculosis (TB) continues to share the major burden of extrapulmonary TB. This burden up to some extent may be attributed to the implementation gap which is reasonably broadest at the level of the immediate point of care. As an orthopedic physician is an important stakeholder at this juncture, it is imperative to recognize their experiences, perceptions, and anticipations to fill this gap. This qualitative inquiry tries to explore these attributes in the context of the recent development at the policy level in Revised National Tuberculosis Control Program. Methodology Type of Study Qualitative inquiry with framework approach. Settings Orthopedic surgeons working in different work settings. Sampling Method Purposive sampling. An iterative topic guide for an in-depth interview was prepared by reviewing the literature and expert opinions. The questions were contextual, diagnostic, evaluative, and strategic. This study adopted a framework approach as the issue was near to evaluative and strategic policy research. The recorded interviews were transcribed and coded into axial and serial codes. A framework matrix was created and thematic mapping was done to understand the phenomena and to offer the solution framework. Results The investigators detected an element of unawareness of the current context coupled with the perceived previous stringency of the program. This is in conjunction with already multifaceted diagnostic and prognostic complexity. This leads to mutual dissociation and skepticism. Conclusion This qualitative inquiry explored an element of dissociation between programmatic objectives and individualistic concerns of the caregivers. An integrated ecosystem which may take care of synergistic reciprocation among the two is imperative for successful implementation.