Caregivers’ needs and challenges in using digital adherence technologies for pediatric tuberculosis treatment: a qualitative study in Indonesia

to explore caregivers’ experiences in supporting medication adherence among children with TB, as well as their readiness, needs, and expectations regarding the use of Digital Adherence Technologies (DAT) in a primary care setting. A qualitative descriptive study was conducted using Focus Group Discussions (FGDs) with purposively selected caregivers of children undergoing TB treatment at the Sukajadi Community Health Center, Bandung, Indonesia. Three focus groups were conducted with a total of 18 caregivers, all of whom were mothers. Data were analyzed using reflexive thematic analysis to capture patterns related to caregiving responsibility, barriers to adherence, digital readiness, and system-level expectations. Four overarching themes were identified. First, Parental Responsibility and Adaptive Strategies, where caregivers perceived medication adherence as a strong moral and emotional obligation, prompting the use of adaptive strategies such as mobile alarms, structured household routines, and family support. Second, Multidimensional Barriers to Treatment Adherence, including children’s behavioral resistance, contextual challenges, and limited or unclear guidance from healthcare professionals. Third, Digital Readiness and Requirements, characterized by varying levels of digital literacy, technical barriers (e.g., storage capacity and password management), and significant concerns regarding data security and privacy, alongside a preference for simple, user-friendly applications. Fourth, System-Level Expectations and Readiness for Innovation, emphasizing the need for empathetic communication from health workers and government support through accessible, free, and data-efficient digital platforms. Caregivers of children with TB in this primary care setting demonstrate readiness to engage with digital adherence technologies; however, successful implementation depends on family-centered, user-oriented design supported by empathetic communication and institutional backing