Table 5 Themes from focus group discussion with clinic staff TB adherence and retention
Theme | Representative quotes from health care workers |
|---|---|
Inadequate patient preparation and education | “Now I am rushed … I am teaching you bits and pieces and say you will see the rest on the paper at home because I am rushing for the queue outside.” |
“It seems better at HIV because, you know, HIV like they have a lot of time than us, they have time for testing, they are taught in classes, and they are prepared before they start pills; with TB, you find out today that you have TB, you start taking pills today.” | |
Stigma | “Maybe they will be afraid that they have TB because it will be said if you have TB you will infect [others] while working, in that way it makes them stigmatized.” |
Initial shock and weakness (as hindering education) | “Others you even finish talking to them and they are just shocked, they can’t even hear what you are saying.” |
“Health education is given to TB patients but because they come weak or have errands, some are disorientated” | |
Denial of diagnosis and treatment | “They just want cough mixture and antibiotics … so now for them to come back for you to give them medication - that’s going to be chronic - is a problem, that’s the biggest problem … They are not here thinking they will get TB, they just are here for a quick fix.” |
Transient catchment population | “We are in town … where they get their buses, taxis and all those things, so a person walks in and they are not from our catchment area so maybe they are from Ianskop or wherever … so we have done screening and we see that they have signs and symptoms … they are not going to come back because they are not coming here for that.” |
Difficulties tracing homeless patients | “There are many people who are homeless, some are living in the streets, some in informal settlements so you find that the patient will come in when they are very sick, they come and take medication … As soon as they feel they are a bit better they will go back to their lives of hustling, so they go back and hustle and it becomes difficult for us to even trace them.” |
Job suspension | “We have a problem with employers … employers, once they find out they have TB they stop them from work, so they need letters from doctors that will say whether the person can continue with working or not.” |