“I mixed the medicine with milk; said it was strawberry flavored”: Parental challenges, coping strategies, and hopes in supporting childhood tuberculosis treatment adherence in Makassar, Indonesia

Abstract

This study explored how parents in Makassar, Indonesia, support childhood tuberculosis (TB) treatment adherence amid emotional, social, and sensory challenges. Seventeen caregivers participated in the in-depth interviews. We conducted a conceptual framework-informed deductive thematic analysis, organizing the findings within seven a priori analytic domains: internal challenges, external challenges, internal coping strategies, external coping strategies, religious coping strategies, expectations of health services, and parental expectations for children and the community. Parents described difficulties with medication schedules, fatigue, stigma, and inconsistent guidance from healthcare workers. To cope, they employed practical and relational strategies: alarms, reframing medicines as "superheroes," offering treats, and prayer. Practices such as mixing medicines with milk revealed counseling gaps and risks for suboptimal adherence. Parents called for clearer communication and family-centered support, alongside hopes for recovery and freedom from stigma. These findings show that childhood TB caregiving is embodied and emotional, requiring culturally responsive and family-centered approaches.

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