title: 'That's when I struggle' … Exploring challenges faced by care givers of children with tuberculosis in Botswana.
abstract: Government-funded public health clinics in and around Gaborone, Botswana.
  
  
  
  To explore the challenges faced by care givers of children on treatment for tuberculosis (TB) to inform a more child-friendly approach to Botswana's National TB Programme (NTP) strategy.
  
  
  
  Qualitative study using 28 in-depth interviews with care givers of children receiving anti-tuberculosis treatment.
  
  
  
  Care givers identified five main challenges: long delays in their child's diagnosis, difficulty attending clinic for daily treatment, difficulty administering TB medications, stock-outs of TB medications leading to treatment interruptions, and inadequate TB education. Care givers prioritized these same five areas to improve the overall management of their child's TB.
  
  
  
  Our findings suggest that despite accessing care through an NTP that adheres to World Health Organization guidelines, care givers for children on treatment in Botswana continue to encounter significant challenges. While each of these represents a potential threat to successful treatment, they can be addressed with relatively small systematic and programmatic adjustments. These results will inform the next version of the Botswana NTP guidelines towards a more child- and care giver-centered approach.
authors.affiliation: University of Pennsylvania, Philadelphia, USA; Center for Public Health Initiatives and Master of Public Health Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Stillson
authors.affiliation: University of Pennsylvania, Philadelphia, Center for Public Health Initiatives and Master of Public Health Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of Botswana, Gaborone, Botswana.
authors.forename: H
authors.initials: H
authors.lastname: Okatch
authors.affiliation: University of Pennsylvania, Philadelphia, Center for Public Health Initiatives and Master of Public Health Program, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: R
authors.initials: R
authors.lastname: Frasso
authors.affiliation: Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana.
authors.forename: L
authors.initials: L
authors.lastname: Mazhani
authors.affiliation: Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana.
authors.forename: T
authors.initials: T
authors.lastname: David
authors.affiliation: University of Pennsylvania, Philadelphia, USA; Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana.
authors.forename: T
authors.initials: T
authors.lastname: Arscott-Mills
authors.affiliation: Botswana-UPenn Partnership, Gaborone, Botswana.
authors.forename: M
authors.initials: M
authors.lastname: Matlhare
authors.affiliation: University of Pennsylvania, Philadelphia, USA; Department of Paediatric & Adolescent Medicine, Faculty of Medicine, University of Botswana School of Medicine, Gaborone, Botswana; The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA; Botswana-UPenn Partnership, Gaborone, Botswana.
authors.forename: A P
authors.initials: AP
authors.lastname: Steenhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000600:supply & distribution / Q000627:therapeutic use; D001902:Botswana; D017028:Caregivers / Q000193:education; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005069:Evaluation Studies as Topic; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D015397:Program Evaluation; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy*; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents