Barriers to childhood tuberculosis case detection and management in Cambodia: the perspectives of healthcare providers and caregivers

Abstract Childhood tuberculosis (TB) case detection remains low in many high-burden countries, including Cambodia. This study aimed to determine the barriers to childhood TB detection and management from the perspectives of healthcare providers and caregivers in Cambodia.We conducted in-depth interviews with 16 healthcare providers from four operational districts and 28 caregivers of children with TB and children in close contact with bacteriological confirmed pulmonary TB residing under the selected districts. Data were analysed using thematic analyses.Identified key barriers to childhood TB case detection and management included inadequate TB staff, limited knowledge on childhood TB, poor collaboration among healthcare providers, limited quality of TB diagnostic tools, and interruption of supplies of childhood TB medicines, lack of collaboration from caregivers, ignorance of healthcare provider's advice, parent movement, transportation costs, out-of-pocket expenditure, time-consuming, no clear explanation from healthcare providers, and aging of caregivers.The national TB program should further invest in staff development for TB, scale-up appropriate TB diagnostic tools and ensuring its functionalities such as rapid molecular diagnostic systems and X-ray machines, strengthen childhood TB drug management at all levels such as drug forecasting, a clear mechanism for drug distribution, and drug monitoring, and increasing community awareness about TB in order to increase community engagement.