Table 1

Barriers and facilitators of TB treatment in the Indian subcontinent: overarching themes (OT), subthemes, associated categories and inductive codes

Overarching themesSubthemesCategoriesEmergent codes
OT#1Influences include interconnections between a patient’s social role in the family, their own priorities in day-to-day living and their experience of the disease

  • Influence of a patient’s social role in the family

  • Influences of their own priorities in day-to-day living

  • Influence of their own experience of the illness

-Social role
-Lifestyle factors
-Disease experience		Caregiver responsibilities, family obligations, marriageability, health-seeking behaviour, alcoholism, migration, confidentiality, fear of getting worse, improved health, not feeling better, motivation, weakness
OT#2How providers treat patients profoundly influences adherence

  • Providers are overburdened with pressure to meet targets, straining their relationship with patients

  • People who do not adhere are labelled ‘difficult’ leading to further discrimination

-Programme structure
-Provider constraints
-Patient-centeredness
-Healthcare Infrastructure
-Treatment characteristics		Programme targets, workload/burden, incentive-structures, training, provider motivation, caste-based discrimination, patient-profiling, previous ‘defaulter’, patient-provider relationship, confidentiality, private sector, delayed diagnosis, drugs stockouts, (un)friendly and (in)flexible treatment, side effect, medication burden, nutrition requirement, cost of treatment
OT#3Beyond the individual-level, accessing service provision is also heavily determined by structural, social, economic and cultural factors pertaining to and influencing the treatment context

  • Although free, accessing TB services costs time and money

  • Information from health providers is often inadequate and confusing

  • Consequences of stigma and need for strong social supportive system

-Resource barriers
-Knowledge and awareness
-Social support		Cost of treatment, nutrition requirement, financial issues, livelihood, transportation, time, access, TB awareness, trust/belief, misinformation, clarity of diagnosis or treatment, insufficient/inadequate information, family support, social support, stigma, marriageability

  • TB, tuberculosis.