Home Institution

Harvard University

Publication Date

Fall 2014

Program Name

Brazil: Public Health, Race, and Human Rights


Objective: The aim of this study is to analyze how Instituto Brasileiro para Investigação da Tuberculose (IBIT), a philanthropic tuberculosis clinic in Salvador, Brazil, maintains treatment abandonment rates much lower than those of surrounding public clinics. This study also aims to evaluate how professionals conceptualize and address the difficulties faced by patients.

Methods: Interviews were conducted with 8 IBIT professionals and 16 patients in treatment for tuberculosis in the aforementioned institution via semi-structured and structured questionnaires, respectively. Participant observation guided the analysis of relationships between patients and professionals.

Results: Patients found varying aspects of treatment difficult depending on personal circumstances, and chose IBIT for its reputation rather than their perceived notion of its ability to meet their needs. Professionals agreed that drug addiction and alcoholism are the largest barriers patients face to completing treatment, with financial difficulties also mentioned. Most professionals believed the quality of the IBIT team and their relationship with patients contributed to treatment success, and that social services explained their low abandonment rates.

Conclusion: IBIT addresses the structural barriers that most patients face to completing treatment by means of their social assistance programs without community-based, daily, directly-observed treatment. While the social services offered are essential to treating patient, just as important is the humanized relationship and patient-centric attitudes that accompany the provision of these services.


Health and Medical Administration | Health Communication | Health Services Administration | Latin American Studies | Medical Education | Medical Humanities | Medicine and Health Sciences | Primary Care | Public Health | Translational Medical Research


Article Location