Tuberculosis (TB) - an old disease that has distressed the human race for more than 4 000 years
- remains a pressing public health concern (Zaman 2010 Krishnan et al. 2014). In South
Africa regardless of applying the Directly Observed Treatment Short-Course (DOTS) strategy
since 1996 and substantial investments and enhancements in TB control the case detection rate
is still far from the goals defined by the World Health Organization (WHO). With 450 000 new TB
infections annually TB is anticipated to bring many repercussions on both mortality and
morbidity of South Africans along with enormous financial consequences for the health system
(Foster et al. 2015 SANAC 2017). The burden of non-adherence to TB treatment has been
affirmed as one of the primary challenges facing global control of TB pandemic (Van den
Boogaard et al. 2011). In a situation where non-adherence to treatment is the consequence of
unjust and avoidable forces equity issue inflates its significance. Although TB services are
free at the point of use in South African public health facilities much is unknown about
overall barriers in access to TB services and their association with treatment adherence.
Gender as a social determinant of health has been reported to impact the access and adherence
to TB services in other settings while genderrelated barriers to TB access have been an
under-researched area in South Africa. This study aims to explore these barriers as well as the
gender-based differences of perceived barriers from the perspective of TB patients who enrolled
in DOTS in South Africa. The following section introduces the overall methodological approach
to the study. It represents the study design the study setting and data sources in addition to
the methods used in data analysis.
