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Table 2 Tasks and responsibilities within the new programme

From: Provider experiences of the implementation of a new tuberculosis treatment programme: A qualitative study using the normalisation process model

Staff category

Tasks within the programme

Administrative responsibilities

Professional nurses

• Diagnosing smear-positive pulmonary TB

• Initiating patients on treatment

• Providing initial directly observed therapy at clinic

• Monitoring patient adherence

• Monthly weighing, taking sputum samples, assessing problems.

• Sending patients to adherence counsellors for counselling.

• Dealing with referrals to the clinic.

• Completing patient-held records (white cards) with calendar to indicate sputum dates, and other clinic appointments

• Keeping track of which treatment supporter is responsible for which patient

• Checking home assessment and counselling sheets; signing patient off for treatment self-administration

Adherence counsellors

• Informing patients of the programme

• Counselling the patient and their buddy about TB, TB treatment, side effects of TB treatment, the importance of good adherence and promoting HIV counselling and testing

• Reporting back to the team about patient's eligibility for the programme

• Filling in intervention register

• Filling in counselling sheet

• Filling in patient name, address and contact number for treatment supporters

• Assigning treatment supporters to patients

• Giving out home assessment forms

Treatment supporters

• Conducting home assessments, identifying TB contacts and individuals at risk of contracting TB in the home and referring children under 5 years of age to the clinic to be assessed for TB treatment or TB preventive therapy

• Reporting back to clinic team meetings on home assessments

• Visiting patients and conducting pill counts after patient placed out: three times in the first week and once a week thereafter until the patient completes treatment

• Reporting back to team meetings on patients that experience problems with taking treatment

• Filling in home assessment forms

• Filling in referral forms

• Filling in forms when patients are not available or have problems with their treatment

• Filling in monitoring forms, including when patient was visited and dates for sputum smear testing

Treatment buddy

• Attending 4 counselling sessions with patient

• Supporting, motivating and reminding patients to maintain treatment adherence in the home

• Reporting problems that patients experience to treatment supporter or clinic