South Africa has one of the world’s highest tuberculosis (TB) incidence rates. Healthcare workers (HCWs) are at particularly high risk of developing active TB compared to the general population, due to their occupational exposures. International guidelines support the routine screening of HCWs for active TB as an effective strategy to reduce the TB burden in high prevalence countries. However, it is estimated that only two-thirds of HCWs in South Africa will utilize available TB services at any point in their career. In this study, multiple data sources including semi-structured interviews, focus groups, observation, site visits, and secondary data analysis were synthesized and analyzed using Porter’s Five Forces Framework of Competitive Position Analysis. The outcomes of this systematic evaluation found TB services available to HCWs in South Africa to be an industry with high rivalry, moderate -to -high bargaining power of the suppliers and a threat of substitutes, low bargaining power of buyers and a limited threat of new entrants. Value opportunities presented through these five forces can enhance the utilization of TB services, reducing TB-associated morbidity and mortality among this high risk, yet often neglected and under-researched population.

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