Challenges and Barriers Faced by People with TB and Healthcare Workers Providing TB Care and Management - A Qualitative Study

In tuberculosis (TB) care and management, there are practical challenges existing at the patient-provider level leading to implementation barriers at the primary care level. The objective of the study is to explore the challenges and barriers faced by people with TB and health-care workers in TB care and management. This study was done as a part of a community intervention study between November 2021 and December 2022. Twenty interviews were taken with treatment for TB (n = 7) and health-care personnel (n = 13). Health-care personnel include nursing staff, medical officers, laboratory technicians, community health workers, and medical personnel from tertiary care hospital. Participants were recruited across all levels of health-care systems. Interviews were carried out in the Hindi language, audio recorded, and translated to English. Participants were asked about their experiences of challenges and barriers faced during TB care and management. Qualitative data were coded, and thematic analysis was done manually. The challenges and barriers at the level of people with TB were issues with communication between providers and people with TB, out-of-pocket expenditure, poor adherence to medicines, lack of proper diet, gender issues, and stigma. The challenges and barriers at the level of health-care providers were a lack of infrastructure and logistics, lack of awareness, COVID-19-related issues, lack of workforce, and technical issues. Communication between providers and people with TB must be improved to improve the drug adherence and satisfaction of the end user. Proper funding must be provided for the TB programs. People with TB must be counseled properly regarding the free health care services available near their homes to prevent out-of-pocket expenditure. These will help in fast-tracking the elimination of TB.