Tuberculosis treatment delivery in Bali: a qualitative study of clinic staff perceptions

SETTING: Little is known about the challenges of delivering tuberculosis (TB) treatment in Indonesia's southern province of Bali. OBJECTIVE: We aimed to explore staff perceptions of TB treatment delivery and barriers to improved TB control in Bali to inform strategies for programme development. DESIGN: Semi-structured interviews were conducted with staff who were involved in the delivery of TB treatment services in the public sector. RESULTS: The main issues perceived by staff to influence TB treatment delivery include: the low level of community awareness of TB; delays to treatment seeking and the frequent use of private treatment providers; diagnostic difficulties; non-adherence to treatment; and a low level of staff education specific to TB. CONCLUSION: Staff perceived a number of significant barriers to the early diagnosis and successful treatment of TB in Bali. The development of strategies to address these identified difficulties in TB control is essential to support improved programme effectiveness and enhanced TB control in Bali.