Introduction: In-hospital treatment of children with tuberculous meningitis (TBM) is not a feasible option in many resource-poor countries. Home-based treatment has shown to be a viable alternative. Adherence is an important factor determining success of treatment.Objective: Identify possible barriers to adherence of home-based treatment and caretaker perception of the disease.Method: A qualitative study consisting of 11 in-depth semi-structured interviews was performed based on principles of the health belief model.Results: Barriers of adherence identified include poor understanding of the disease and transmission route, difficulty with medication administration and side effects, lack of access to the health-care facility, long waiting times and hidden costs of transportation. Caretakers showed good appreciation of the adverse effects of noncompliance and benefits obtained from taking treatment in the home environment.Conclusion: Improved doctor-patient communication, information brochures, structural changes to hospital settings, provision of financial and peer support all contribute to optimal TBM home-based treatment. © The Author . Published by Oxford University Press. All rights reserved.