Bridging the gap between policy and practice: a qualitative analysis of providers' field experiences tinkering with directly observed therapy in patients with drug-resistant tuberculosis in Addis Ababa, Ethiopia.

摘要: Objectives Drug-resistant tuberculosis (DR-TB) is one of the major public health threats in low-income countries such as Ethiopia. It intertwined with larger socioeconomic and political factors that complicate its management control. Whether directly observed therapy (DOT) serving purpose—better patient adherence treatment outcome—still remains a debatable issue. To contribute to this discussion, study explored workers’ field experiences tinkering DOT patients DR-TB Addis Ababa, Design A qualitative using in-depth interviews focus group discussion. Setting Ten healthcare facilities: eight centres at Ababa Health Bureau level two TB-specialised hospitals Federal Participants 18 providers working patients. Results Three findings emerged from analysis. First, purpose ensure go facilities swallow pills under observation provider. Thus, rigid application could lead emergence more DR-TB. Second, should be tinkered practice improved by incorporating counselling education, flexibility towards, attentiveness of, context. Third, there exists family-like patient-provider relationship, do understand their empathise them provide better services. Conclusion If rigidly implemented, DR-TB—a problem was invented resolve. Front-line are sensitive tragic them. they not strictly implement willing take any blame resulting it. high time shape for patients, meaningful contributions front-line providers.