Table 5 The main challenges that trained DR-TB teams face in providing DR-TB care as mentioned by supervisors (N = 14) and trained DR-TB teams (N = 15)

Stigma in the community and stigma among DR-TB patients

There is still stigma towards patients who wear masks

HCWs: Stigma is very high irrespective of the Health Education every Wednesday {1 participant}

We are told by patients to go without mask due to fear of being stigmatized. (1 participant}

Inadequate infrastructure

There are inadequate waiting areas, inadequate space for patient management and poor ventilation

Inadequacy in the system of drug delivery

There is shortage and delays in (short regimen) drugs

Delays in laboratory results

Sometimes there are no culture results at all

It can take 5 – 6 months to receive the results

Delays in getting investigation results especially culture results (even in KIDH) {9 participants}

Modules for GeneXpert need replacement {1 participant}

Working conditions and staff capacity building are not up to standard

2 staff were transferred out and no new staff brought-in

Few staff but involved in other programs without replacement

No extra-duty to staff working on holidays

in KIDH 32 more staff members were employed, their challenge is to build the capacity of this new staff

There is a lack of refresher training

Modalities for home visits are not clear {2 participants}