Management and Control of Childhood Tuberculosis In Southern Ghana

Abstract

ABSTRACT The WHO has called for commensurate attention to childhood TB. However, there is limited research evidence to inform context-specific policies and implementation. Therefore, this study explores the management and control of childhood TB in Ghana. Data were obtained from 31 health providers and 35 primary caregivers for TB-infected children from 15 health facilities in five regions in Ghana. Using the Normalisation Process Model and Salutogenic theory as frameworks, qualitative analyses were done using QSR Nvivo 12 plus. The study found that childhood TB management and control practices in the selected health facilities were largely consistent with recommended practices, though several challenges such as the absence of paediatricians to conduct sputum induction procedures such as gastric lavage exist. Treatment interruption after the intensive phase and contact tracing difficulties were also pronounced. Service providers and primary caregivers are favourably disposed to the idea of partial integration of childhood TB management into child welfare clinics. To improve the management and control of childhood TB, service providers recommended among other things; getting childhood TB firmly on the public health agenda, improving childhood TB active case finding (ACF), and addressing loss to follow-up. Childhood TB exerts considerable negative psychosocial impacts on primary caregivers, TB-infected children, and their households at large. The theoretical frameworks provided a broader understanding of the contextual issues. The National TB Control Programme and the GHS should consider partial integration of childhood TB services into child welfare clinics and provide psychosocial support to primary caregivers.