Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.

<h4>Background</h4>Even though there are different tuberculosis (TB) prevention and control measures implemented globally including Ethiopia, TB is still major public health problem. This is partly due to compromised quality of care delivered for tuberculosis patients in health facilitie...

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Main Authors: Chalachew Genet, Tesfaye Andualem, Addisu Melese, Wondemagegn Mulu, Feleke Mekonnen, Bayeh Abera
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0234988
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author Chalachew Genet
Tesfaye Andualem
Addisu Melese
Wondemagegn Mulu
Feleke Mekonnen
Bayeh Abera
author_facet Chalachew Genet
Tesfaye Andualem
Addisu Melese
Wondemagegn Mulu
Feleke Mekonnen
Bayeh Abera
author_sort Chalachew Genet
collection DOAJ
description <h4>Background</h4>Even though there are different tuberculosis (TB) prevention and control measures implemented globally including Ethiopia, TB is still major public health problem. This is partly due to compromised quality of care delivered for tuberculosis patients in health facilities (HFs) during diagnosis, treatment and follows-up. Thus this study is intended to determine the quality of care delivered for TB patients in all public HFs of Debre Tabor town, Northwest Ethiopia.<h4>Methods</h4>Cross sectional study was conducted from January to May 2018. Data were collected with face-to-face interview and TB registration book review using structured questionnaire and checklist respectively. Collected data was entered and processed using SPSS and P value <0.05 was considered statistically significant. The quality of care for each HF was graded as very good, good, moderate, poor and very poor if HFs achieve [90-100%], [80-90%), [70-80%), [60-70%) and <60% of performance indicators respectively using Donabedian structure, process and outcome model of health care quality.<h4>Results</h4>All HFs have sputum collection area, enough microscopic slide, at least one functional microscope and sufficient anti TB drug supply. But HFs lack backup laboratory stains. Overall structural aspects of quality of care in all HFs were very poor achieving 42.5-52.9% structural performance indicators out of 100%. Similarly the overall process aspects of quality of care was poor in all public HFs which achieved 60-68.9% of the scores out of 100%. In the study; 68.9%, 54.5% and 80.6% of Medical Laboratory, pharmacy and other healthcare workers (HWs) provided correct response respectively on TB causative agent, risk factor, transmission, treatment, prevention, case management and case finding strategies. HWs who knew at least two TB case finding strategies in DTH was significantly higher than those HWs working in Health Centers (P = 0.004). On the other hand, except Ginbot 20 HC, HFs was graded as good by scoring 86.6-89.3% of performance indicators on the outcome aspects of quality of care. In all HFs studied, all TB patients' unit TB registration number, sex, age, TB category, treatment initiation date and intensive phase treatment start year were properly registered. Moreover 110 (78%) and 147 (69%) contact person address in DTH and HCs was properly registered on TB unit register book respectively with no statistical difference in hospital and HCs (P = 0.063). There was proper TB patients' address registration in hospital than HCs studied (P< 0.001).<h4>Conclusions</h4>The outcome aspects of quality of care for TB patients in all HFs were promising. But structural & process aspects of quality of care was compromised which necessitate different corrective actions to be taken by different stakeholders to enhance quality of care for TB patients in public HFs studied. Moreover based on the study findings, continuous supply of drugs, laboratory equipment and reagents, availing current guideline/s in HFs, providing up-to-date training for HWs on TB and proper documentation are important to improve quality of care provided for TB patients.
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spelling doaj.art-1cd8e4ac37d6493fbd892a68c0f57fc92022-12-21T18:25:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01156e023498810.1371/journal.pone.0234988Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.Chalachew GenetTesfaye AndualemAddisu MeleseWondemagegn MuluFeleke MekonnenBayeh Abera<h4>Background</h4>Even though there are different tuberculosis (TB) prevention and control measures implemented globally including Ethiopia, TB is still major public health problem. This is partly due to compromised quality of care delivered for tuberculosis patients in health facilities (HFs) during diagnosis, treatment and follows-up. Thus this study is intended to determine the quality of care delivered for TB patients in all public HFs of Debre Tabor town, Northwest Ethiopia.<h4>Methods</h4>Cross sectional study was conducted from January to May 2018. Data were collected with face-to-face interview and TB registration book review using structured questionnaire and checklist respectively. Collected data was entered and processed using SPSS and P value <0.05 was considered statistically significant. The quality of care for each HF was graded as very good, good, moderate, poor and very poor if HFs achieve [90-100%], [80-90%), [70-80%), [60-70%) and <60% of performance indicators respectively using Donabedian structure, process and outcome model of health care quality.<h4>Results</h4>All HFs have sputum collection area, enough microscopic slide, at least one functional microscope and sufficient anti TB drug supply. But HFs lack backup laboratory stains. Overall structural aspects of quality of care in all HFs were very poor achieving 42.5-52.9% structural performance indicators out of 100%. Similarly the overall process aspects of quality of care was poor in all public HFs which achieved 60-68.9% of the scores out of 100%. In the study; 68.9%, 54.5% and 80.6% of Medical Laboratory, pharmacy and other healthcare workers (HWs) provided correct response respectively on TB causative agent, risk factor, transmission, treatment, prevention, case management and case finding strategies. HWs who knew at least two TB case finding strategies in DTH was significantly higher than those HWs working in Health Centers (P = 0.004). On the other hand, except Ginbot 20 HC, HFs was graded as good by scoring 86.6-89.3% of performance indicators on the outcome aspects of quality of care. In all HFs studied, all TB patients' unit TB registration number, sex, age, TB category, treatment initiation date and intensive phase treatment start year were properly registered. Moreover 110 (78%) and 147 (69%) contact person address in DTH and HCs was properly registered on TB unit register book respectively with no statistical difference in hospital and HCs (P = 0.063). There was proper TB patients' address registration in hospital than HCs studied (P< 0.001).<h4>Conclusions</h4>The outcome aspects of quality of care for TB patients in all HFs were promising. But structural & process aspects of quality of care was compromised which necessitate different corrective actions to be taken by different stakeholders to enhance quality of care for TB patients in public HFs studied. Moreover based on the study findings, continuous supply of drugs, laboratory equipment and reagents, availing current guideline/s in HFs, providing up-to-date training for HWs on TB and proper documentation are important to improve quality of care provided for TB patients.https://doi.org/10.1371/journal.pone.0234988
spellingShingle Chalachew Genet
Tesfaye Andualem
Addisu Melese
Wondemagegn Mulu
Feleke Mekonnen
Bayeh Abera
Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.
PLoS ONE
title Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.
title_full Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.
title_fullStr Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.
title_full_unstemmed Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.
title_short Quality of care for tuberculosis patients in public health facilities of Debre Tabor town, Northwest Ethiopia.
title_sort quality of care for tuberculosis patients in public health facilities of debre tabor town northwest ethiopia
url https://doi.org/10.1371/journal.pone.0234988
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