Assessment of Patient Satisfaction with TB Care Services in Southern Afghanistan

Muhammad Haroon Stanikzai,1 Hazratullah Bariz,1 Zabihullah Anwary,2 Ahmad Haroon Baray,1 Jawad Shirzad,1 Omid Dadras3 1Department of Public Health, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan; 2Department of Clinic, Faculty of Medicine, Bost University, Lashkar Gah, Helmand, Afghanistan; 3Public Health Division, Department of Health, Darwin, AustraliaCorrespondence: Muhammad Haroon Stanikzai, Department of Public Health, Faculty of Medicine, Kandahar University, District # 10, Kandahar, 3801, Afghanistan, Tel +93704775578, Email haroonstanikzai1@gmail.comBackground: Patient satisfaction is an important measure of high-quality TB care. However, no study has investigated patient satisfaction with TB care services in Afghanistan. Therefore, this study aims to assess patient satisfaction with TB care services in Southern Afghanistan.Methods: Between October and December 2025, a cross-sectional study was carried out among adult TB patients, who were randomly selected from six TB care centers in Southern Afghanistan. The outcome variable was patient satisfaction, assessed by the Patient Satisfaction Questionnaire-18 (PSQ-18). Bivariate and multivariable logistic regression models were fitted to identify factors associated with patient dissatisfaction.Results: Of 413 patients, 44.5% (95% CI: 39.6%– 49.4%) were dissatisfied. The domains with the lowest satisfaction scores were financial aspects, followed by time spent with doctors. Patients living in rural areas (AOR = 1.72; 95% CI: 1.07– 2.77), with lower household income (AOR = 1.73; 95% CI: 1.07– 2.79), incurring out-of-pocket treatment costs (AOR = 1.68; 95% CI: 1.06– 2.67), being in the continuation phase (AOR = 1.83; 95% CI: 1.12– 2.98), not receiving counselling (AOR = 7.25; 95% CI: 3.86– 13.61), and currently smoking (AOR = 2.05; 95% CI: 1.16– 3.60) had greater odds of dissatisfaction with TB care.Conclusion: Nearly half of the TB patients were not satisfied with TB care. Policymakers and healthcare providers should address the determinants of dissatisfaction, particularly socioeconomic barriers, healthcare inequities, limited counselling, and regional disparities, to improve TB care programs in Southern Afghanistan.Keywords: tuberculosis, patient satisfaction, quality of TB care, health service accessibility, Afghanistan