Addressing barriers in paediatric tuberculosis reporting: A qualitative study of private healthcare providers’ perspectives

Introduction: Tuberculosis (TB) in children poses a global health challenge, contributing to high morbidity and mortality rates. In 2020, approximately 208,000 TB-related deaths occurred in children under 15 years, many due to under-reporting, particularly in the private healthcare sector. Barriers to TB notification include hesitancy and misconceptions, lack of awareness and training, technological challenges, stigma, and regulatory issues. Method: This qualitative study examined primary care physicians’ perspectives on the under-reporting of TB cases through in-depth semi-structured interviews with 15 physicians from private practices and clinics in Indonesia. Data collection was between May and July 2024. Thematic analysis, supported by NVivo 12 software, was used to identify key themes, and findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: The analysis revealed two primary themes: Barriers to Tuberculosis Notification and Social and Policy Impacts on Tuberculosis Notification. Under the first theme, five sub-themes were identified: Hesitancy and Misconceptions, Lack of Awareness and Training, Technological and Logistical Barriers, Stigma and Confidentiality Concerns, and Regulatory and Enforcement Issues. These findings highlight the complex factors influencing TB notification practices in the private sector. Conclusion: Addressing these barriers through targeted interventions is essential for improving paediatric TB notification rates. This study underscores the need for enhanced training, better regulatory frameworks, and improved collaboration between private practitioners and public health authorities to ensure timely diagnosis and treatment of paediatric TB.