Figure 1
Figure of participant selection.
Figure 2
Photos of medications used as reference tools.
Table 1
Qualitative data matrix.
| ILLUSTRATIVE QUOTE | IDI V FGD |
|---|---|
| Theme per Wademan’s Framework of Acceptability: Manipulation and administration of DR‑TB medication | |
| “I was breaking it up and I was grinding it and put it in water and mix it with the… small white one and one red one and they would dissolve so I mixed them in a container…” | FGD, P3, child 10 months |
| “… ah, we give him in the morning, I used to give him at 4:H00 because…” | IDI 3, child 7 months |
| “I would wake up in the morning and prepare for my other children who were already in school, and so by six am I was already up and at that time I would give Paser also whilst busy tiding up the house the porridge would be cooking and at around 8 am I knew that I had to administer the rest of the medication before he ate porridge.” | FGD, P3, child 10 months |
| “my five‑year‑old can talk for herself, and she always says ‘will you buy Danone (yoghurt) or juice for me when I finish drinking my medication?’” | IDI 1, child 5 years |
| “When he said that it is bitter, I would put my hand in my pocket and promise to give him R5.00 ($0.27) and encourage him to take his medicines and… on Saturday, I would decrease the amount to R2.00 ($0.11) and we would build it up as the week goes.” | FGD, P4, child 3 years |
| “That’s the tablet that would change her demeanor, and sometimes she would even cry, and my uncle’s wife would help me to hold her.” | IDI 1, child 5 years |
| “He would change his face because they are bitter, so suddenly… he just doesn’t like them, he cries when he is going to be given these pills…” | FGD, P3, child 10 months |
| “I would have to hold him and pin him down.” | IDI 3, child 7 months |
| “I would use a syringe and just push it forcefully and tell him to swallow, and he would swallow very quickly, and maybe if I have some sweets next to me, then I would give it to him, but other times, he just drank his medication without a hassle.” | FGD, P2, child 18 months |
| “He used to say that it made his tummy hurt, and he felt tired and nauseous. He would beg me not to give [medication] to him or try to bargain with me that I give him his medication on the following day or later, he kept running from taking them.” | IDI 2, child 3 years |
| “…after taking it, he would refuse to eat, saying he may throw up, and he needs time and maybe he would eat around 10 am since the morning” | IDI 2, child 3 years |
| “I would wake up in the morning and prepare for my other children who were already in school | |
| “No, shame they are very bitter and so it was just a fight, the moment he woke up he was ready (for a fight), and I too would make haste to administer medication to him.” | IDI 2, child 3 years |
| Theme per Wademan’s Framework of Acceptability: Interface with the healthcare system: caregivers caught in the middle | |
| “… and it was painful to see him cry too when we had to leave him, it was just the worse and the most torturous experience ever.” | FGD, P3, child 10 months |
| “Hmm, I used to cry, and I cried a lot [it was it difficult] it was not easy at all.” | IDI 1, child 5 years |
| “Hospital staff asked us to come and witness how they administer medication so that we too as parents could see the struggle and learn how we will cope” | FGD, P4, child 3 years |
| “I was coming to this hospital and when I finally arrived, they treated us with dignity and gave me a bed to sleep in even though I came a day before I was expected to come. The next day the necessary tests were done, and I left…” | FGD, P1, child 10 months |
| “…I couldn’t see her; I called her until I found out that she had gotten used to the hospital; it was good for her, and she would tell me that she had aunties in the hospital who bathed her and taught her new things in life. I realized that I needed to let my heart be at peace and know that my child would be okay.” | FGD, P4, child 3 years |