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Table 1 The outcome space for the district leaders’ perceptions of managing the DOT program in Trang Province, Thailand

From: Thai district Leaders’ perceptions of managing the direct observation treatment program in Trang Province, Thailand

(4) Need for improvement
Motivation
For district leaders: Extrinsic motivation
For VHVs: Extrinsic motivation and intrinsic motivation
In the health system: Community participation
New practices in the TB guidelines
District leaders: Having a family member as a mentor
Health system: Having effective informational materials for village health volunteers
(3) Practical dilemmas (2) Achieving a full recovery
Fear of infection Need for trust
District leaders: Fear of infection District leaders:
VHVs: Fear of infection Trust the TB patients and their families
TB patients and their families: Fear of participation restriction TB patients and their families: Having self-awareness or self-responsibility
Mutual distrust Needs of care
District leaders: District leaders: Home visits and follow ups
Don’t trust TB patients and their families VHVs: Empowering TB patients and their families
VHVs: Unsuitable TB patients and their families:
TB patients and their families: Don’t trust village health volunteers Empowerment, caring, and health education
Inadequate knowledge about TB Necessity of community participation
District leaders: Insufficient knowledge to conduct the DOT program Good cooperation among stakeholders (district leaders, VHVs, TB patients and their families, villagers)
VHVs: Insufficient knowledge to perform the DOT program
(1) Compliance with the TB treatment program guidelines
Management of the DOT program follows the guidelines of the national TB program
Health education training for village health volunteers