Tuberculosis Treatment Adherence: Evaluating Healthcare System Factors and Other Contributing Elements

Abstract

Tuberculosis remains a major global public health concern despite being preventable and curable. Effective treatment of tuberculosis requires strict adherence to anti-TB medications for at least four to six months under recommended treatment protocols. However, poor adherence continues to contribute to treatment failure, relapse, prolonged infectiousness, multidrug-resistant tuberculosis (MDR-TB), and increased mortality. Globally, tuberculosis remains one of the leading infectious causes of death, with millions of people affected annually. World Health Organization reports that poor treatment completion contributes significantly to drug resistance and weakens TB control efforts. (World Health Organization)

 This study discusses tuberculosis treatment adherence by evaluating healthcare system factors and other contributing elements responsible for poor adherence. Healthcare system-related factors such as long waiting time, distance to treatment centres, poor attitudes of healthcare workers, inadequate counselling, drug shortages, poor communication, rigid clinic schedules, inadequate staffing, and limited access to healthcare services are examined. The study also evaluates socio-economic, personal, medication-related, and psychosocial factors such as poverty, stigma, low educational level, treatment fatigue, substance abuse, family support, forgetfulness, and fear of medication side effects.

 The study adopts the Health Belief Model (HBM) as its theoretical framework because it explains how patients’ beliefs, perceptions, motivations, and enabling factors influence treatment behaviour. The study argues that treatment adherence is multidimensional and influenced by interactions among health system, personal, socio-economic, and environmental determinants. Therefore, improving adherence requires patient-centred interventions involving effective counselling, strengthened healthcare delivery, social support, financial assistance, and flexible community-based TB programmes.