Table 2. Direct participant quotes: Perceived need for post-TB services.

Theme	Sub-theme	Quotes
Not a priority at present	Need to focus on public health	“There are more pressing issues. It is not that this is not important and I am sure it is very important to an individual that goes through this but in the greater scheme of things and in a resource-constrained environment you are going to choose the things that are most common that affect more people. That is the public health perspective. So unfortunately that is the harsh reality.” (MoH staff, Malawi)
	An external agenda	“This is not something that is discussed all the time and it has become important because someone somewhere has decided it is important.” (MoH staff, Malawi)
An important agenda	Need to inform patients about their health	“I feel it is very necessary because most people after completing their medication they actually do not know what next. I feel it would be very important so that they have some guidance on what else after the medication, what else after you get cured” (TB patient advocate, Kenya) “Let me speak it from my own point of view. Like for me, I would have found it more helpful if there were already systems in place because I would not have to feel like I am disturbing my surgeon with all those questions. I would have been more comfortable.” (TB-survivor, Kenya) “We do have a lot of patients. TB is quite a burden in Malawi so yes, it means every year we are discharging people from treatment so a lot of post-TB care candidates are coming out of our system each year and those need support and some level of attention to maintain their health in good check. So we do need to have that agenda.” (Researcher, Malawi) “So because on the cut-off date when they do the last tests and declare you free of TB, that is the end of the visitation, the end of going to the clinic, the end of everything. So they have left you with all the problems that you have been talking to them without getting any responses. So for me, I feel that it would have been important to still continue for some time so that they continue to monitor you and they come to a conclusion where you are also satisfied to say I have finished my treatment.” (TB Survivor, Malawi)
	Need for standardised patient pathways	“I think it is something that we should be advancing because patients are there and we need to have a unified approach to their care because now I believe they are being seen by different doctors everywhere who may make different diagnoses and manage them differently.” (Healthcare provider, researcher and lecturer, Kenya) “…we discussed with my colleagues within the department and at one point or another we refer these patients to the physicians who follow them up. From there we lose track of the patient. We do not have that mechanism of knowing how they have picked up from the consultant level.” (Healthcare Provider, Kenya) “That is why what we have done, we are liaising with our colleagues to say look, instead of saying NCD clinic, ART clinic, TB clinic, why don’t we just say a chronic disease clinic so that when a patient comes in, it is either we are giving them the TB drugs, they are getting ARTs, they are also getting the NCD drugs. In so doing, we will be able to manage these patients under one roof. So that is the integration that we want to have.” (MoH staff, Malawi) “As I said, if you look at TB, HIV and NCDs, I think this just needs to be one family because HIV patients they have TB, they develop NCDs so it is something that yes the three of us we have to be related. So yes, I would say it is good. It is something that needs to be done.” (MoH staff, Malawi)
	Opportunity to maximise the investment made during TB treatment	“Oh yes. It does not make sense that you invest millions in a person, you cure them and then after that they do not lead normal lives. I mean then what you have invested becomes a waste” (TB Patient advocate, Kenya) “I have observed that within one or two years the close contact of the same patients are coming to the hospital with the TB. So if we have a very well structured way of following up the post-TB cases, we can be able to pick the contacts early enough even without much of interruption or without them spreading to other people. So a timely agenda that if possible it needs to be in place”. (Non-governmental Organisation, Kenya)
	Means of reducing ongoing health seeking	“…I think [post-TB morbidity] is really rendering these people unproductive because they will spend a lot of time maybe seeking care, they will get all sorts of diagnosis and maybe put on all sorts of antibiotics or other medication and it is going to be expensive for them. It is going to drain their resources in time. From the healthcare system, I think it is also similar. It is a waste of resources because we are not giving these patients the care that they need maybe right from the time that they completed their TB treatment” (Multilateral Organisation–TB policy)