Dissaving In the Era of “Free” Care for Tuberculosis (TB): A Qualitative Exploration of Financial Coping and Enablers Among Patients with Co-Prevalent TB-HIV/ TB-Diabetes in Bhavnagar Region, Western India

Background: India reports the highest number of cases tuberculosis (TB) in India. Patients with TB employ negative financial coping mechanisms (dissaving) to make up for costs care. Our objectives were explore dissaving employed and enablers perceived by patients TB-HIV, TB-diabetes, program managers TB. Methods: We conducted qualitative in-depth interviews among eight TB-HIV patients, TB-diabetes seventeen Bhavnagar region (western part India). An interview guide focusing on strategies was used. Interviews audio-recorded, transcribed, analyzed using thematic analysis (codes categories). Results: Borrowing money, taking a loan interest, selling jewellery, employment spouse, mortgaging assets co-infection/ comorbidity. Free diagnosis, free treatment, accessible health facilities, support from workers, bi-directional screening, collaborative integration some managers. Conclusions: Even settings decentralized “free” model care, co-prevalent TB-HIV/ offset The cash transfer scheme should be realigned meet protection targets zero catastrophic year 2030.