Evidence mapPaperPMID 42392631Full record

ArticleBMJ open2026

Providing person-centred TB care: a participatory study with healthcare workers in Nairobi, Kenya.

Beate Ringwald, Edel Sakwa, Rhoda Pola Karisa, Chrispine Okoth, Veronicah Mwania, Rachael Thomson, Kerry Millington, Brenda Mungai, Eliya M Zulu, Leila Hussein Abdullahi

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Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Beate RingwaldCentre for Tuberculosis Research, Liverpool School of Tropical Medicine, Liverpool, UK beate.ringwald@lstmed.ac.uk.ORCID http://orcid.org/0000-0002-3950-3145
Edel SakwaAfrican Institute for Development Policy, Nairobi, Kenya.
Rhoda Pola KarisaPublic Health and Research, Respiratory Society of Kenya, Nairobi, Kenya.ORCID http://orcid.org/0000-0002-6040-7123
Chrispine OkothPublic Health and Research, Respiratory Society of Kenya, Nairobi, Kenya.
Veronicah MwaniaAfrican Institute for Development Policy, Nairobi, Kenya.
Rachael ThomsonCentre for Tuberculosis Research, Liverpool School of Tropical Medicine, Liverpool, UK.
Kerry MillingtonCentre for Tuberculosis Research, Liverpool School of Tropical Medicine, Liverpool, UK.ORCID http://orcid.org/0009-0007-1988-1847
Brenda MungaiAfrican Institute for Development Policy, Nairobi, Kenya.
Eliya M ZuluAfrican Institute for Development Policy, Nairobi, Kenya.ORCID http://orcid.org/0000-0002-8680-4311
Leila Hussein AbdullahiAfrican Institute for Development Policy, Nairobi, Kenya.ORCID http://orcid.org/0000-0002-7198-0558

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolicies promote patient-centred tuberculosis (TB) care in Kenya, a high-burden TB country, but implementation remains limited. This study sought to understand the experiences of TB healthcare workers in implementing patient-centred TB services in primary health facilities in Nairobi and explore how the challenges they face can be addressed.

methodsUsing collaborative research design, we recruited healthcare workers (n=29) from primary health facilities across three densely populated subcounties in Nairobi and TB stakeholders (n=24) including policymakers and managers. From March to April 2024, we collected data through three workshops with nurses (n=19) and clinical officers/doctors (n=10) and a joint workshop with stakeholders. Participants engaged in group discussions and participatory visual methods to define person-centred care, document practices, identify challenges and develop solutions. Our data analysis applied a framework approach drawing on the social-ecological, TB care cascade and health systems building blocks models.

resultsHealthcare workers identified practices for differentiated TB care across age groups, genders, occupations and comorbidities. Implementation faced multiple challenges including structural, health system, community and patient's individual constraints. Shortages of funding, workforce and capacity affected close-to-community TB screening (Theme 1). Insufficient testing capacity at lower-level facilities led to diagnostic delays (Theme 2). Inflexible clinic hours and medication stockouts requiring frequent facility visits undermined TB treatment and adherence among working populations (Theme 3). Weak collaboration and referral systems limited support for people facing homelessness, substance use or poverty. Healthcare workers proposed enhanced TB training, increased TB workforce, flexible medication delivery, integrated TB services and strengthened intersectoral collaboration with education, labour and social protection sectors (Theme 4).

conclusionsHealthcare workers demonstrate willingness and capacity to deliver patient-centred TB care but require strengthened health systems, ongoing training and sustainable intersectoral partnerships. Scaling up identified practices and innovative tools while addressing systemic barriers could improve TB care delivery and outcomes for underserved populations.

Indexed as

Health PersonnelPatient-Centered CarePrimary Health CareTuberculosisAdultFemaleHumansKenyaMaleHealth WorkforcePerson-Centered CareTuberculosis

Identifiers

PMID42392631
PMCPMC13331128

What Socratic holds

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.