Provider experiences of the implementation of a new tuberculosis treatment programme: a qualitative study using the...

Area of Science:

• Public Health
• Health Services Research
• Infectious Disease Management

Background:

• Tuberculosis (TB) treatment outcomes remain poor in many regions, contrasting with successful antiretroviral treatment (ART) programs.
• The ART program model's success in adherence and outcomes suggests potential for improving TB treatment.
• Assessing staff reception is crucial for implementing new TB treatment models based on ART program successes.

Purpose of the Study:

• To explore healthcare staff perceptions of a new TB treatment program modeled on the ART program.
• To identify factors influencing the implementation and normalization of the new TB treatment program.
• To utilize the normalization process model to analyze staff experiences with the intervention.

Main Methods:

• Qualitative approach utilizing interviews and focus group discussions with clinic staff.
• Data collected from five intervention clinics.
• Analysis involved qualitative content analysis, organized under the constructs of the normalization process model.

Main Results:

• Staff identified significant challenges in program implementation.
• Key barriers to normalization related to interactional workability, relational integration, and skill-set workability.
• Issues included hierarchical relationships, teamwork, training needs, and insufficient internalization of the empowerment approach.

Conclusions:

• The normalization process model effectively categorized implementation challenges.
• Further work is required to address identified issues before wider program implementation.
• Substantial effort is needed to embed the intervention into routine clinic practices for successful TB treatment.