Perceptions, Barriers, and Opportunities to Strengthen Tuberculosis Prevention and Control in Nigeria: A Qualitative Study of Policymakers and Program Managers
Abstract:
Policymakers and program managers play a critical role in shaping tuberculosis (TB) control strategies, yet their perspectives on implementation barriers remain underexplored. This qualitative study examined perceptions of TB control, preventive activities, and implementation challenges in Nigeria. Nine key informants from national and subnational TB programs and partner organizations were purposively selected. Data were collected through in-depth interviews and analyzed thematically in NVivo 12. Participants reported progress in TB control, including the expansion of community-based services, improved access to diagnostics, the scale-up of tuberculosis preventive therapy (TPT), and strengthened monitoring systems. However, these gains are constrained by persistent system-level and contextual barriers. Stigma, low awareness, and financial constraints limit uptake of preventive services, while workforce shortages, staff attrition, supply chain inefficiencies, and reliance on paper-based reporting undermine program effectiveness. Respondents emphasized the need for service integration, increased domestic financing, and accelerated digitalization. TB control efforts in Nigeria are advancing but remain constrained by structural limitations. Addressing these gaps will require coordinated strategies to strengthen health systems, expand access, and improve program efficiency.References:
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