Background: Defaulters are producing the challenging, daunting category of drug resistant cases. It is important to examine and understand the patient′s notions and terms to manage them effectively. Objective: To study the reasons behind failure of adherence to treatment and to assess the health care seeking behaviour with awareness of these patients regarding the public sector provisions. Materials and Methods: In depth interviews with ten patients who had defaulted and were undergoing CAT-II treatment which included both retreatment defaulters and new defaulters, were conducted by repeated contacts in Fatehpur Beri PHC DOTS centre. Results: People refuse to seek treatment from a government health centre when they fall sick seriously as they are ready to get treated at any expense and seek private health care facility for the prompt treatment. There is a notion that free service from public sector is not as effective as private corporate hospitals. In the public sector patients defaulted because of side effects of drugs, fear of getting admitted in big tuberculosis (TB) hospitals, incompatible timing, neglect, long waiting time, TB deaths in the family and lack of family support. Among migrants, lack of employers support, family support forced them to return home. Ignorance about existence of DOTS centre with free treatment was observed. Most of the patients were unaware that incomplete treatment could lead to disease. Misconceptions observed were that treatment was futile (talk in the community about drugs being useless) and most of the patients were afraid of the disease and thought they could die because of it. Conclusion: Proposed measures include: Recognition of traditional medicine/complementary alternative medicine practitioners for universal access to TB diagnosis and care, Public sector should be made attractive to the middle class society through enhancement of services and user fees and empowerment initiatives for lack of social support of the migrants.

Health care seeking behavior migrant DOTS centre Adherence to treatment

hospital admission unspecified side effect health seeking behavior community care employer human Health Behavior middle aged death social support alternative medicine qualitative research interview Young Adult migrant family Treatment Outcome tuberculostatic agent male traditional medicine female tuberculosis short course therapy clinical article Article organization and management patient compliance adult drug safety health care access government tuberculosis control health care system health center health care facility empowerment health practitioner