Psychosocial Factors That Influence Adherence to Direct Observation Treatment Among Tb Patients in Accra Metropolis.

ABSTRACT

Background: TB disease is curable, however, despite the initiation of DOTS recommended by WHO to control the epidemic; the disease remains a major public health problem globally and in Ghana. This issue can be associated with Non-adherence to DOTS among TB patients, which has resulted in an increase in TB mortality and severe forms of TB, difficult to cure. Therefore, there is the need to investigate the psychosocial factors that influence adherence to DOTS among TB patients in Accra Metropolitan. Method: A qualitative approach using phenomenology was employed to explore participants’ experiences regarding adherence to DOTS. Thirty (30) IDIs and three (3) KIIs were conducted in three purposively sampled health facilities (Greater Accra Regional Hospital, Kaneshie Polyclinic, and Achimota Hospital). The data collected was transcribed, coded and analyzed for the generation of themes with the aid of qualitative data analysis software “Nvivo version 11.0”. Results: The participants had good knowledge of TB as well as DOTS practices. According to the participants, perceptions, and outcomes of DOTS positively influenced on DOTS. On the other hand, unwillingness to visit facilities for treatment and desire for smaller drug sizes were some of the unfavorable perceptions. Again, adverse emotional experiences such as fear of the unknown and the motivation for treatment positively influenced adherence to DOTS. Socially, support from health workers and other significant others were factors which influenced adherence to DOTS positively and adversely. Patient challenges as well as health system challenge were some barriers hindering the implementation of DOTS. Conclusion: Therefore, the NPT should intensify public education as well as provide the tangible support required to overcome these barriers.