An ethnographic study on TB control program in Pakistan

Objective: To describe discrepancies in implementation of DOTS (Directly Observed Treatment Short-course) program of WHO to eliminate Tuberculosis in government healthcare centers of tehsil Murree, Pakistan. Methodology: A sample of 15 healthcare personnel was purposively selected and data were collected through participant observation, nonparticipant observation and in-depth interviews. A semi-structured interview guide was used. Results: X-ray facility was not available on Basic Health Units (BHUs). The residents of Tehsil Murree were not having easy access to X-ray facility of government hospitals. The staff of government hospitals had no interest in TB program because they had considered it as an extra burden. The TB staffs of these centers were not being given any financial compensation in form of daily or travel allowance for official work. Recording and reporting system was outdated. Conclusion: There was gross failure of TB control program in area we surveyed. Least political will and lack of financial resources had remained a root cause for this.