title: 'Sustaining the DOTS': stakeholders' experience of a social protection intervention for TB in Nigeria.
abstract: Social protection for TB patients can lower patient costs and improve adherence. The aim of this study was to explore patients' and health workers' experiences of a social protection intervention for TB in order to inform a more patient-centred approach for the Nigeria National TB Programme strategy.
  
  
  
  This was a qualitative study consisting of 103 in-depth interviews and two focus group discussions with patients who received the intervention, and 10 key informant interviews with health workers. A thematic content analysis of the interviews was performed.
  
  
  
  Of those who completed the interviews, 53 (51.5%) were male, and 69 (67.0%) were below 40 years. Most of the participants received care and support from their families but delayed access to TB services due to lack of funds for transportation, nutritional supplementation and non-TB drugs. The intervention had a high level of acceptability and uptake; particularly clear benefits emerged for most patients who used the social protection funds to purchase food and supplements, other drugs, transportation and additional personal necessities. Some patients assert that the financial incentive package increased their awareness of timing of their follow-up visits. In addition, health workers observed increased enthusiasm to treatment and improvement in adherence among participants.
  
  
  
  Patients and health workers reported positive experiences with the financial incentives provided for TB treatment.
authors.affiliation: Department of Internal Medicine, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
authors.forename: Kingsley N
authors.initials: KN
authors.lastname: Ukwaja
authors.affiliation: National Tuberculosis and Leprosy Control Programme, Ministry of Health, Abakaliki, Ebonyi State, Nigeria.
authors.forename: Isaac
authors.initials: I
authors.lastname: Alobu
authors.affiliation: KNCV Tuberculosis Foundation/TB CARE I Project, Abuja, Nigeria.
authors.forename: Gidado
authors.initials: G
authors.lastname: Mustapha
authors.affiliation: KNCV Tuberculosis Foundation/TB CARE I Project, Abuja, Nigeria.
authors.forename: Olajumoke
authors.initials: O
authors.lastname: Onazi
authors.affiliation: Department of Community Health and Psychiatry, University of West Indies (UWI), Mona, Kingston 7, Jamaica.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Oshi
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000379:methods*; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D009549:Nigeria; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D011640:Public Policy; D036301:Qualitative Research; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000523:psychology / Q000628:therapy*; D016903:Drug Monitoring
keywords: Adherence; Cash transfer; Drug-susceptible TB; Incentives and enablers; Nigeria; Qualitative study