Representative quotations on negative HCW attitudes and behaviours towards patients
| HCW attitude or behaviour | Representative quotation |
| Scolding patients | Q32. The doctor scolded me, ‘Why didn’t you come at the time the infection started?’ (Man with a prior treatment history). |
| Stigmatising behaviour | Q33. They (staff in the hospital) treated me in an irreverent way. (Family member of a man without a prior treatment history) |
| Q34. (D)octors don’t have enough time to talk to patients. The staff nurse can counsel patients, but they treat the patients as untouchables. (Participant in a health visitor FGD). | |
| Violation of confidentiality or disclosure of diagnosis | Q35. (When the TB diagnosis has been disclosed), patients will ask us, ‘Why did you share my information with the (community) leader?… Who gave you the right to share information regarding my disease condition with others?… What will others think about me?’ (Participant in a health visitor FGD describing the type of language used by patients after disclosure of diagnosis). |
| Coercion | Q36. Sometime we used to blackmail irregular patients by using permanent ID proof. For example, we got a driving license as proof of identification from an auto rickshaw driver (patient). Then we said to him, ‘If you take treatment irregularly, we will cancel your driving license.’ (Participant in a senior treatment supervisor FGD). |
| Demanding bribes for further care | Q37. Ward staff in the hospital were asking for bribes for towing patients to the X-ray department. (Man with a prior treatment history). |
| Delays in patient registration | Q38. We generally assign TB Numbers within a week or within 2 weeks. If the patient is regular (on TB therapy), then we assign the TB Number the same day, but in the case of category II patients (ie, those with a prior treatment history), we take two or more days for giving the TB Number. (Participant in a senior treatment supervisor FGD). |
| Refusal of care to patients | Q39. They (nurses or supervising providers) do not want to care for the patient. For default cases (ie, prior treatment history)… the nurse will say, ‘Send him out. Don’t give him a strip of tablet.’ Or, ‘Why are you giving him tablets?’ (Participant in a health visitor FGD describing the type of language used by some HCWs towards some patients). |
FGD, focus group discussion; HCW, healthcare worker; TB, tuberculosis.