par Huygens, Pierre ;Macq, Jean ;Laokri, Samia ;Dujardin, Bruno
Référence TM & IH. Tropical medicine and international health, 12, Supplement 1, page (132-132)
Publication Publié, 2007
Article révisé par les pairs
Résumé : Objectives: FORESA3 is an operational research programme aiming at improving health care making it more sensitive to patients’ expectations and needs. Taking TB as an entry-point to criticize health systems in four West African countries implementing ‘patient-centred approach’ (PCA), the project ultimately research dysfunctions and strategies to overcome them. Methods: Qualitative operational research has been used, questioning health practitioners and other actors on results obtained in the field by a multidisciplinary team of socioanthropologists and public health specialists about access to TB care and prevention. 160 semi-structured interviews were conducted in the 4 sites together with direct observation. Participatory methods of group discussions were also used. Data were transcribed in French and analysed using Atlas-ti. Results: The method proved efficient in stimulating reflexivity on health practices and interactions amongst health workers and politics. In the field, new synergies were created with the civil society, notably between traditional healers and health workers. However, the extension to be given to the well-known concept of PCA was found variable according to the actors. Causes of resistances to change attitudes and practices amongst Health Workers will be elicited from the data. Conclusion: Restitution of socioanthropological feed-back data from the civil society about their perceptions and expectations of the ‘patient-centred approach’, often demonstrates controversies according to the actors. Arena of discussions around PCA often tells us more about the motivations of ‘holders’ criticizing or establishing the legitimacy of powers around the stake of patients ‘wellbeing’.