Treatment adherence under the foucauldian perspective: knowledge/powers in tuberculosis control manuals in Brazil

Abstract

Objective Investigate which knowledge emerges in the Tuberculosis Control Manuals and how power relations are established for treatment adherence. Method Documentary and qualitative research on five Manuals published between 2002 and 2019, available on the Ministry of Health’s Website, based on Michel Foucault’s theoretical and methodological framework. Results 1. Knowledge: emerges as human resource training; health surveillance actions; medicalization; and multifunctionality of nurses in addressing the social determinants of tuberculosis. 2. Power relations: occur through articulation between different subjects and establish disciplines on the body and the behavior of the person undergoing treatment. Conclusions Certain knowledge/powers constitute the actions of treatment adherence to tuberculosis treatment and normalize the “correct/true” way of conducting disease control. Such behaviors refer to self-responsibility, autonomy and empowerment of the subject and do not consider the countless conditions of vulnerability existing in the history of people with tuberculosis.

A critical analysis of the decreasing trends in tuberculosis cure indicators in Brazil, 2001–2022

“…Directly observed treatment, for example, has been crucial to guarantee the bond between health professionals and affected people, allowing early identification of possible loss to follow-up and favoring the chances of curing the disease. 21 , 23 , 24 …”

“…Directly observed treatment, for example, has been crucial to guarantee the bond between health professionals and affected people, allowing early identification of possible loss to follow-up and favoring the chances of curing the disease. (21,23,24) Federative Furthermore, to effectively combat tuberculosis, it is crucial to reinforce actions aimed at controlling and managing cases of latent Mycobacterium tuberculosis infection (LTBI), also known as tuberculosis infection. (25) In these situations, people are not sick, but when exposed to risk factors, such as immunosuppression or malnutrition, they can develop an active condition, and, eventually, spread tuberculosis among contacts, maintaining the transmission chain.…”

Factores asociados al tratamiento no exitoso para tuberculosis en pacientes previamente tratados en Cali, Colombia, en el periodo 2015-2019

“…La educación del paciente suele ser subvalorada, factor que puede favorecer la circulación de conceptos erróneos que dificultan la participación de los pacientes en su tratamiento y afectan sus decisiones (41,42). Por lo tanto, el ofrecer información clara, oportuna y comprensible del porqué y para qué del tratamiento (43,44) y el adaptarla según las características propias del paciente (45), puede favorecer el éxito del tratamiento y promover comportamientos saludables.…”