Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Tolulope Osoba

Abstract

Tuberculosis (TB) remains the leading cause of death in South Africa, with higher mortality rates among men compared to women, despite the availability of free TB services and a reduction in TB death rates. However, research on the factors influencing men's access to and utilization of TB services is limited. The purpose of this study was to assess the factors affecting men's geographical access and quality utilization of TB services in the Zululand district of KwaZulu Natal province, South Africa. A survey questionnaire was used to collect data from 200 men recruited from selected primary health care facilities. Andersen's model of health services utilization and the social-ecological model were used as theoretical frameworks. Logistic regression was used for inferential statistical analysis. The findings revealed that age, income level of R1 – R3500, and level of TB knowledge were significant factors influencing men's quality utilization of TB services, while travel time to health facilities, and mode of transport influenced geographical access. Age was negatively associated with quality utilization of TB services, with older men having lower quality utilization (OR = .98, p = .037). Level of TB knowledge was a significant predictor of men's quality utilization of TB services, with higher knowledge associated with higher utilization (OR = 3.71, p = .002; OR = 3.6, p = .003 adjusted for age). Recommendations for positive social change include male-targeted community campaigns and health education for early diagnosis, treatment and control, community financial empowerment through public and private partnerships, bringing TB services closer to the community to promote access, and implementing triggers to improve medication adherence and avoid treatment interruptions.

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