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Table 1 TB control challenges

From: The impact of pastoralist mobility on tuberculosis control in Ethiopia: a systematic review and meta-synthesis

a) Adequacy
-  Limited experience [26], lack of supervision [28] and in-service training [27] for the staff on duty.
-  Poor staffing quality [28]
-  Incomplete record keeping [28]
-  Insufficient level of decentralisation [18, 24]
-  Inadequate health infrastructure [24]
-  Absence of professionals during working hours [28]
-  Long waiting time [26, 28]
b) Adherence
-  High default rate due to pastoral mobility contrasted with static health facilities [28]
c) Availability
-  Shortage of trained staff [18, 24]
-  Intermittent shortages/stock outs of drugs and laboratory supplies [26, 28]
d) Targeting accuracy
-  Inadequate Acid-Fast Bacilli (AFB) microscopy follow-up [28]
-  Very low detection rate [18, 32] and low sensitivity of diagnosis (microscopy) [18]
e) Acceptability
-  Lack of trust of health extension workers [27]
-  Preference of traditional medicinal practices [24, 26]
-  Perceived symptoms as self-limiting [27]
f) Accessibility
-  Services are only available in major towns and villages along main roads [24]
-  Inaccessibility of service [27], including lack of transport infrastructure [24]
-  Long distance to travel for service [16, 23, 24, 27]
g) Affordability
-  Higher expenses incurred during the first two months of treatment [24]
-  Cost of transportation and housing during the intensive phase [16, 24, 26, 27]