4.2.1. Adherence to Treatment
Patients default on treatment for different reasons, such as no longer feeling sick, lack of knowledge, personal or cultural beliefs, lack of access to healthcare facilities, lack of motivation, and poor relationship with healthcare workers. Non-adherence is one element that impacts negatively on the quality of nursing care. Below are the comments made by the participants. 
Nurse (N4) indicated that: “The major problem that we have is that (emotional) our hospital is a rural-based and most patients are from the poor backgrounds; so, they always default their treatment for various reasons, such; continue to receive TB grant, bad side effects of medication, social problems and long distances to the clinics where they should collect their medications; lack of money to buy food since TB drugs make them eat more.”
Nurse (N2) added that: “There is a high TB prevalence in surrounding rural areas. Some of them default because they go to traditional healers and the healers tell them that they have been bewitched; they are not really sick. When those patients come back to the hospital their condition will be bad and most of them do not survive a week. Some patients continue to smoke and drink alcohol and worsen their conditions as they fail to adhere to their treatment.”
The findings of this study revealed that patients continued to default treatment for different reasons, such as experiencing side effects, alcohol abuse, cultural and religious beliefs, and lack of access to healthcare facilities. Some default because they wanted to continue receiving the TB grant. The findings of this study concur with those of a study that was done by Herrero et al. [17], which listed the barriers contributing to poor TB treatment compliance, such as communication difficulties, low literacy level, inadequate knowledge and low awareness of TB disease, patients’ attitudes and beliefs in treatment efficacy, depression and other psychiatric illness, alcohol and substance abuse, unstable living conditions, negative health provider attitudes, stigma and discrimination, overcrowding, and access to medicine.