Background: Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods: Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results: Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions: Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

Thesis (MPH.) -- University of Limpopo, 2019 / Background: Tuberculosis still continues to be a global public health problem and leads to many deaths. In an effective TB control strategy, TB patients are allocated to community care workers who provide care to these patients in their homes. It is important to understand the experiences of community care workers in order to strengthen TB control in the country. Objective(s): The purpose of this study was to explore lived experiences of community care workers of supporting patients taking Tuberculosis treatment. Methods: The design of the study was phenomenological, exploratory, descriptive, and contextual. The study site was Hlogotlou area in Limpopo Province. The target population was all community care workers supporting patients on Tuberculosis treatment. Purposive sampling was used with a sample of 13 participants, which was determined by the saturation of data. Semi-structured interviews were conducted using an interview guide and all sessions were audio recorded. The data were analysed using Interpretative Phenomenological Analysis. Results: The results highlighted certain challenges met by community care workers. Patients thought that community care workers are there to kill them with treatment, they had mood swings during treatment and this caused them to use vulgar words and become aggressive to their community care workers. Most community care workers did not have enough information about Tuberculosis. This made it difficult for them to support patients on tuberculosis treatment. Conclusions: A good relationship with patients enhances treatment compliance. The researcher recommends that intensive training about tuberculosis should be provided to community care workers.