Implementation of the DOTS strategy in the control of TB in Paraiba: between the political commitment and the involvement of the teams of the family health program (1999-2004)

• Published in: Ciência & saude coletiva Vol. 16; no. 9; pp. 3917 - 3924
• Main Authors: de Sá, Lenilde Duarte, de Andrade, Marclineide Nóbrega, Nogueira, Jordana de Almeida, Villa, Tereza Cristina Scatena, de Figueiredo, Tânia Maria Ribeiro Monteiro, de Queiroga, Rodrigo Pinheiro Fernandes, de Sousa, Maria Clemilde Mouta
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01-09-2011
• Subjects: Brazil; Directly Observed Therapy; Diseases; Family Health; Government Programs; Health policy; Humans; Medical service; Politics; Program Evaluation; Tuberculosis; Tuberculosis - prevention & control; Brazil
• ISSN: 1413-8123; 1678-4561
• DOI: 10.1590/S1413-81232011001000028

The scope of this paper is to analyze the implementation of the Directly Observed Treatment Short-Course (DOTS) strategy in the control of tuberculosis, from the standpoint of the coordinators of the Tuberculosis Control Program (TCP) in six priority municipalities in the state of Paraíba, Brazil. Semi-structured interviews were conducted with seven TCP coordinators. Five municipalities proved to be DOTS success points achieving a 90% cure rate. Among the DOTS weak points in the political dimension, the following aspects were identified: lack of continuity of the TCP coordinator position; lack of preparedness of the local team; precarious technical-administration structure and insufficiency of the laboratory network. In the operational dimension, the search for respiratory symptoms by the Family Health Teams is still low. Changes of an epidemiological, operational and political nature have been incorporated, though the implementation and guarantee of the sustainability of DOTS in the State depends on the way the health services are organized and on the manager's political commitment to support the strategy.