Perceptions, Enablers and Barriers of Utilization of Tuberculosis Screening Program Among Health Care Workers in Selected Healthcare Facilities in Mazabuka District of Southern Province

Abstract Tuberculosis (TB) remains a major occupational health risk among health care workers (HCWs), particularly in high TB burden settings such as Zambia. Despite the availability of TB screening programs, utilisation of these services among HCWs remains suboptimal. The World Health Organisation (WHO) recommends screening HCWs for TB in high burden settings, but this is often not implemented. The aim of the study was to explore the perceptions, enablers and barriers of utilisation of TB screening among HCWs in selected healthcare facilities in Mazabuka District of Southern Province. The study adopted a qualitative phenomenological research design, targeting 30 health care workers from selected public healthcare facilities in Mazabuka District. Data were collected using in-depth interviews (IDIs) and focus group discussions (FGDs). Thematic analysis was employed to analyse the data. Ethical considerations such as informed consent, confidentiality and voluntary participation were strictly observed. The findings revealed that HCWs generally hold positive perceptions toward TB screening and recognize its importance for occupational safety and infection prevention. However, positive perceptions alone did not guarantee consistent participation. Enablers included institutional support through provision of personal protective equipment (PPE), screening test kits, presence of TB focal persons or champions, peer mentorship, clear operational protocols and accessibility to rapid diagnostic tools. Conversely, major barriers included fear of stigma from colleagues and supervisors, high workload, staffing constraints, limited institutional awareness campaigns and poorly disseminated screening guidelines. TB screening participation among HCWs is influenced by interconnected individual, social and institutional factors. Strengthening screening uptake requires a comprehensive approach that addresses stigma, improves institutional support systems, enhances communication of guidelines and ensures operational feasibility. The findings provide evidence to inform policy and practice aimed at improving occupational health and TB control within healthcare facilities in Zambia.