Joining the DOTS in Bali: private practitioners' perceptions of tuberculosis control

SETTING: The Indonesian island of Bali has both a national public tuberculosis (TB) programme and a significant private sector that provides treatment for patients with TB.

OBJECTIVE: To explore private practitioners' perceptions of barriers to the treatment of patients with TB in Bali to inform strategies for future programme development.

DESIGN: Semi-structured interviews were conducted with private practitioners who treated TB patients in their private practice.

RESULTS: The main barriers to improved TB control in Bali identified by private practitioners reflect difficulties encountered within the following four areas: patient non-adherence to treatment, limitations of public services, public-private integration and limitations of private services. Private practitioners identified the need for improvements in the level of community education regarding TB, the degree of public-private interaction, the quality of diagnostic services and practitioner access to training.

CONCLUSION: This study identified both strengths and weaknesses for TB control in the private sector, as well as considerable variations in perceptions and practice among private practitioners. The development of strategies to address these difficulties and utilise the inherent strengths of both public and private practitioners will be essential for improved service provision and TB control in Bali.