Challenges and solutions in improving tuberculosis care among aboriginal people in Taiwan

Abstract

Indigenous Taiwanese, the minority population in Taiwan, have one-third the annual income of, and a lifespan ten years shorter than, other Taiwanese populations. Despite three decades of government support including free vaccinations, screening, and treatment, implementation of Directly Observed Therapy and worker's compensation for patients during treatment, tuberculosis (TB) remains the ninth leading cause of death among indigenous Taiwanese with an incidence rate ten folds higher than other Taiwanese. While most efforts to improve TB control for indigenous Taiwanese continue to focus on medical services, this study aimed to discuss the cultural and socioeconomic challenges of implementing TB control plans within a minority Taiwanese population and several strategies to address these challenges. Several socio-economical impediments to TB care and their consequences were discussed in this paper, including inconvenience of transportation, financial difficulties, barriers in understanding health care information and alcohol dependence. In addition, faith-based organizations, such as churches, have played an important role in educating Taiwan aborigines. This study suggested two strategies to overcome observed socioeconomic obstacles: enhancing collaboration with faith-based organizations within local aboriginal communities and implementing day care and after school care as a supplementary measure to facilitate hospitalization care among severe TB aborigines. In conclusion, unique social and economic factors should be considered in order to create TB control programs sensitive to aboriginal needs.