title: Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers' and Tuberculosis Control Program Coordinators' Perspectives.
abstract: Background. Weak health systems pose many barriers to effective tuberculosis (TB) control. This study aimed at exploring health worker's and TB control program coordinator's perspectives on health systems challenges facing TB control in West Gojjam Zone, Amhara Region, Ethiopia. Methods. This was a qualitative descriptive study. Eight in-depth interviews with TB control program coordinators and two focus group discussions among 16 health workers were conducted. Purposive sampling was used to recruit study participants. Thematic analysis was used to identify and analyse main themes. Results. We found that intermittent interruptions of laboratory reagents and anti-TB drugs supplies, absence of trained and motivated health workers, poor TB data documentation, lack of adherence to TB treatment guideline, and lack of access to TB diagnostic tools at peripheral health institutions were challenges facing the TB control program performance in the study zone. Conclusions. Ensuring uninterrupted supply of anti-TB drugs and laboratory reagents to all health institutions is essential. Continuous refresher training of health workers on standard TB care and data handling and developing and implementing a sound retention strategy to attract and motivate health professionals to work in rural areas are necessary interventions to improve the TB control program performance in the study zone.
authors.affiliation: Amhara Regional State Health Bureau, P.O. Box 495, Bahir Dar, Ethiopia; Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, 0318 Oslo, Norway.
authors.forename: Senedu B
authors.initials: SB
authors.lastname: Gebreegziabher
authors.affiliation: Amhara Regional State Health Bureau, P.O. Box 495, Bahir Dar, Ethiopia; Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, 0318 Oslo, Norway; Oslo University Hospital, 0424 Oslo, Norway; Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403 Oslo, Norway.
authors.forename: Solomon A
authors.initials: SA
authors.lastname: Yimer
authors.affiliation: Institute of Health and Society, University of Oslo, P.O. Box 1130, Blindern, 0318 Oslo, Norway.
authors.forename: Gunnar A
authors.initials: GA
authors.lastname: Bjune