The expansion of the treatment observed (TS) for the control of tuberculosis in Paraiba (2000/2005)

Abstract

The supervised treatment (TS) is a pillar of the DOTS strategy (Directly Observed Treatment Short-course) and its adoption has been recommended for the control of tuberculosis (TB). The study aimed to analyze the strengths and weaknesses in the expansion process of the supervised treatment in six cities considered as priorities for the TB control in Paraíba-PB/Brazil. The qualitative research used semi-structured interview with 21 professionals involved in the implementation and expansion of DOTS in the cities, data were analyzed through thematic content analysis. As strengths it was identified: support to managers in the decentralization process of TS to the Family Health Units (USF); professionals’ engagement and good communication between USFs and references. Among the reported weaknesses it is observed the lack of support from managers to ensure infra-structure and financial incentive to the professional; lack of professional qualification; high professional turnover and centralization of drug distribution. Despite the efforts for the TS implementation, it is recognized that its expansion is subject to the managerial ability and the managers’ political commitment.