Clinic staff perceptions of tuberculosis treatment delivery in Bali.

A number of studies have investigated patient perceptions of tuberculosis (TB) treatment delivery, but few have systematically investigated the perceptions of clinic staff. We therefore conducted individual interviews using Q-methodology with 25 staff directly involved in the delivery of TB treatment services in 18 different public sector health centres in Bali. Factor analysis was used to identify shared perceptions of TB treatment delivery in Bali among the sample studied. Three distinct perspectives emerged, indicating that all staff do not have shared understandings of difficulties and priorities in TB treatment. The main areas of difference in staff perceptions concerned the existence of barriers to treatment and the focus on the community context of TB treatment. The demonstrated variation in the perceptions of TB treatment delivery in Bali has important implications for the design of strategies to improve treatment delivery and the control of TB.