Social capital and community TB care in the Free State, South Africa

Abstract

Where do TB patients turn for help in the South African health care system? Do they go to a clinic or a community health centre for ambulant treatment, thus retaining contact with their families and local communities? Or are they hospitalised, which means that they can no longer perform their normal duties? In order to answer these questions, a data set was compiled on the basis of oral interviews with a stratified random sample of 310 pulmonary TB patients in the Free State province. A logistic regression analysis of the data revealed that TB patients who can rely on an extended network of relationships, with relatively large amounts of social capital at their disposal, generally make use of clinic treatment and community TB care. Clinics play a central role in TB control programmes, not only as a locus of treatment, but also as a point from which patients can be referred to higher echelons in the healthcare system.