The Existing Problems in the Tuberculosis Control Program of Iran: A Qualitative Study

Introduction: The TB control program in the world has encountered serious problems because of weakness in case detection, inadequate and improper treatment, drug resistance and the emerging and concurrent epidemic of HIV. Therefore, this qualitative study was conducted in order to gain a deep and better understanding of the problems and to suggest initiatives to improve the situation. Method: A qualitative content analysis study was carried out by semi-structured interviews with key informants of the tuberculosis control program in Iran. Participants were selected by purposeful sampling. The trustworthiness of the study was confirmed by the four criteria of credibility, dependability, confirmability and transferability. Data analysis was performed using framework analysis and the main themes and subthemes were identified. Results: Twenty four subthemes and six themes were identified as followings: 1) strategies and policies, 2) characteristics of human resources, 3) quality and quantity of resources, 4) the basis of the methods, 5) coordination and communication and 6) general public participation and social support. Conclusion: Different factors have led to the weakness of the program. In order to improve the current situation and alleviate the problem, it is necessary to improve the processes of diagnosis and treatment, TB reporting system, physician compliance to the National protocol of tuberculosis control, public education, recruitment of TB coordinator physicians, the practice of TB diagnosis laboratory staff and other diagnostic and treatment facilities. Keywords: Tuberculosis, Case finding, Treatment, Qualitative researc