Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives.
<h4>Background</h4>The tuberculosis (TB) and diabetes mellitus (DM) co-epidemic continues to increase globally. Low-and middle-income countries bear the highest burden of co-epidemic, and Ghana is no exception. In 2011, the World Health Organisation (WHO) responded to this global challen...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0235914 |
| _version_ | 1819025973389033472 |
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| author | Rita Suhuyini Salifu Khumbulani Welcome Hlongwana |
| author_facet | Rita Suhuyini Salifu Khumbulani Welcome Hlongwana |
| author_sort | Rita Suhuyini Salifu |
| collection | DOAJ |
| description | <h4>Background</h4>The tuberculosis (TB) and diabetes mellitus (DM) co-epidemic continues to increase globally. Low-and middle-income countries bear the highest burden of co-epidemic, and Ghana is no exception. In 2011, the World Health Organisation (WHO) responded to this global challenge by launching a collaborative framework with a view to guide countries in implementing their DM and TB care, prevention and control plans. Subsequently, several countries, including Ghana, adopted this framework and began implementing bidirectional screening of TB and DM patients. Almost a decade later since the launch of the framework, the implementation of bidirectional screening in Ghana has not been subjected to empirical research. This study explored the barriers and facilitators to bidirectional screening through the lenses of the implementing healthcare workers.<h4>Methods</h4>This was an exploratory qualitative study conducted in three public health facilities offering both TB and DM services in Northern Ghana. In-depth interviews, document review and observations, were used to generate data. In total twenty-three healthcare workers (doctors, nurses, prescriber, health managers and TB task- shifting officers delivering care in TB and DM clinics) were interviewed, using semi-structured interview guides. The interview questions solicited information on the screening process, including knowledge of the collaborative framework, comorbidity, collaboration and workload.<h4>Results</h4>Six themes emerged from the analysis, of which two (Increase in staff capacity, and Institutionalisation of bidirectional screening) were facilitators, and four (Delays in screening, Fear and stigmatization of TB, Poor collaboration between TB and DM units, and Skewed funding for screening) were barriers.<h4>Conclusions</h4>The implementation of bidirectional screening at public health facilities in Ghana was evident in this study and increased staff capacity, funding and institutionalisation enhanced the policy implementation process. However, the screening of TB patients for DM is yet to be prioritised, and emphasis should be put on the design for cost-effective screening approaches for low- and middle-income countries. |
| first_indexed | 2024-12-21T05:19:11Z |
| format | Article |
| id | doaj.art-574377bcfa194b77b08df5e5750d0263 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T05:19:11Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-574377bcfa194b77b08df5e5750d02632022-12-21T19:14:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01157e023591410.1371/journal.pone.0235914Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives.Rita Suhuyini SalifuKhumbulani Welcome Hlongwana<h4>Background</h4>The tuberculosis (TB) and diabetes mellitus (DM) co-epidemic continues to increase globally. Low-and middle-income countries bear the highest burden of co-epidemic, and Ghana is no exception. In 2011, the World Health Organisation (WHO) responded to this global challenge by launching a collaborative framework with a view to guide countries in implementing their DM and TB care, prevention and control plans. Subsequently, several countries, including Ghana, adopted this framework and began implementing bidirectional screening of TB and DM patients. Almost a decade later since the launch of the framework, the implementation of bidirectional screening in Ghana has not been subjected to empirical research. This study explored the barriers and facilitators to bidirectional screening through the lenses of the implementing healthcare workers.<h4>Methods</h4>This was an exploratory qualitative study conducted in three public health facilities offering both TB and DM services in Northern Ghana. In-depth interviews, document review and observations, were used to generate data. In total twenty-three healthcare workers (doctors, nurses, prescriber, health managers and TB task- shifting officers delivering care in TB and DM clinics) were interviewed, using semi-structured interview guides. The interview questions solicited information on the screening process, including knowledge of the collaborative framework, comorbidity, collaboration and workload.<h4>Results</h4>Six themes emerged from the analysis, of which two (Increase in staff capacity, and Institutionalisation of bidirectional screening) were facilitators, and four (Delays in screening, Fear and stigmatization of TB, Poor collaboration between TB and DM units, and Skewed funding for screening) were barriers.<h4>Conclusions</h4>The implementation of bidirectional screening at public health facilities in Ghana was evident in this study and increased staff capacity, funding and institutionalisation enhanced the policy implementation process. However, the screening of TB patients for DM is yet to be prioritised, and emphasis should be put on the design for cost-effective screening approaches for low- and middle-income countries.https://doi.org/10.1371/journal.pone.0235914 |
| spellingShingle | Rita Suhuyini Salifu Khumbulani Welcome Hlongwana Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives. PLoS ONE |
| title | Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives. |
| title_full | Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives. |
| title_fullStr | Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives. |
| title_full_unstemmed | Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives. |
| title_short | Barriers and facilitators to bidirectional screening of TB-DM in Ghana: Healthcare workers' perspectives. |
| title_sort | barriers and facilitators to bidirectional screening of tb dm in ghana healthcare workers perspectives |
| url | https://doi.org/10.1371/journal.pone.0235914 |
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