UNDERSTANDING COST PRIORITIES IN DOTS IMPLEMENTATION FOR TUBERCULOSIS: A CONSENSUS FROM PUBLIC HEALTHCARE PERSONNELS
DOI:
https://doi.org/10.55197/qjmhs.v5i1.191Keywords:
tuberculosis, DOTS, health economics, digital adherence technologies, nominal group techniqueAbstract
Adherence to tuberculosis (TB) treatment is essential for effective TB control. However, inadequate documentation of the specific cost drivers associated with the implementation of Directly Observed Therapy, Short-course (DOTS) in routine care hinders evidence-based resource planning. This study employed a modified nominal group technique with TB healthcare workers in Malaysian government healthcare facilities to reach consensus on essential cost factors in standard DOTS management for treatment adherence. Participants achieved agreement on six key cost domains, encompassing both provider and patient perspectives. These include investment in digital monitoring tools, staff fieldwork allowances, additional human resources, infrastructure support, patient financial support, and patient transportation. Digital DOTS tools, such as video-observed therapy, along with workforce incentives, have been identified as primary priorities. The findings offer valuable insights for health policymakers, emphasizing areas where targeted resource allocation can enhance cost-effectiveness and improve TB programme efficiency. The results provide a framework for optimizing tuberculosis programme budgets by clarifying cost priorities in DOTS implementation and guiding resource planning. The insights derived from consensus facilitate strategic policy decisions aimed at enhancing treatment adherence and ensuring the sustainability of tuberculosis control programs.
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Copyright (c) 2026 AHMAD AMIRUL SHAFIQ MOHD, NURHUDA ISMAIL, KHALID IBRAHIM, AMIR ZHARIF ADENAN, LENY SUZANA SUDDIN
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