Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study
Abstract Background The World Health Organization estimated that 1.12 million children developed tuberculosis (TB) in 2018, and at least 200,000 children died from TB. Implementation of effective child contact management is an important strategy to prevent childhood TB but these practices often are...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05324-0 |
| _version_ | 1818304674772549632 |
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| author | Yael Hirsch-Moverman Joanne E. Mantell Limakatso Lebelo Andrea A. Howard Anneke C. Hesseling Sharon Nachman Koen Frederix Llang Bridget Maama Wafaa M. El-Sadr |
| author_facet | Yael Hirsch-Moverman Joanne E. Mantell Limakatso Lebelo Andrea A. Howard Anneke C. Hesseling Sharon Nachman Koen Frederix Llang Bridget Maama Wafaa M. El-Sadr |
| author_sort | Yael Hirsch-Moverman |
| collection | DOAJ |
| description | Abstract Background The World Health Organization estimated that 1.12 million children developed tuberculosis (TB) in 2018, and at least 200,000 children died from TB. Implementation of effective child contact management is an important strategy to prevent childhood TB but these practices often are not prioritized or implemented, particularly in low- and middle-income countries. This study aimed to explore attitudes of healthcare providers toward TB prevention and perceived facilitators and challenges to child contact management in Lesotho, a high TB burden country. Qualitative data were collected via group and individual in-depth interviews with 12 healthcare providers at five health facilities in one district and analyzed using a thematic framework. Results Healthcare providers in our study were interested and committed to improve child TB contact management and identified facilitators and challenges to a successful childhood TB prevention program. Facilitators included: provider understanding of the importance of TB prevention and enhanced provider training on child TB contact management, with a particular focus on ruling out TB in children and addressing side effects. Challenges identified by providers were at multiple levels -- structural, clinic, and individual and included: [1] access to care, [2] supply-chain issues, [3] identification and screening of child contacts, and [4] adherence to isoniazid preventive therapy. Conclusions Given the significant burden of TB morbidity and mortality in young children and the recent requirement by the WHO to report IPT initiation in child contacts, prioritization of child TB contact management is imperative and should include enhanced provider training on childhood TB and mentorship as well as strategies to eliminate challenges. Strategies that enable more efficient child TB contact management delivery include creating standardized tools that facilitate the implementation, tracking, and monitoring of child TB contact management coupled with guidance and mentorship from the district health management team. To tackle access to care challenges, we propose delivering intensive community health education, conducting community screening more efficiently using standardized tools, and facilitating access to services in the community. |
| first_indexed | 2024-12-13T06:14:27Z |
| format | Article |
| id | doaj.art-59059fa5667d454a8fc9de5ef38ed1cb |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-13T06:14:27Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-59059fa5667d454a8fc9de5ef38ed1cb2022-12-21T23:57:00ZengBMCBMC Health Services Research1472-69632020-05-012011810.1186/s12913-020-05324-0Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative studyYael Hirsch-Moverman0Joanne E. Mantell1Limakatso Lebelo2Andrea A. Howard3Anneke C. Hesseling4Sharon Nachman5Koen Frederix6Llang Bridget Maama7Wafaa M. El-Sadr8ICAP at Columbia University, Mailman School of Public HealthHIV Center for Clinical & Behavioral Studies, Division of Gender, Sexuality and Health, at the New York State Psychiatric Institute and Columbia University Irving Medical Center, Department of PsychiatryICAP at Columbia University, Mailman School of Public HealthICAP at Columbia University, Mailman School of Public HealthDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch UniversityPediatric Infectious Diseases, SUNY Stony BrookICAP at Columbia University, Mailman School of Public HealthLesotho Ministry of Health National Tuberculosis ProgramICAP at Columbia University, Mailman School of Public HealthAbstract Background The World Health Organization estimated that 1.12 million children developed tuberculosis (TB) in 2018, and at least 200,000 children died from TB. Implementation of effective child contact management is an important strategy to prevent childhood TB but these practices often are not prioritized or implemented, particularly in low- and middle-income countries. This study aimed to explore attitudes of healthcare providers toward TB prevention and perceived facilitators and challenges to child contact management in Lesotho, a high TB burden country. Qualitative data were collected via group and individual in-depth interviews with 12 healthcare providers at five health facilities in one district and analyzed using a thematic framework. Results Healthcare providers in our study were interested and committed to improve child TB contact management and identified facilitators and challenges to a successful childhood TB prevention program. Facilitators included: provider understanding of the importance of TB prevention and enhanced provider training on child TB contact management, with a particular focus on ruling out TB in children and addressing side effects. Challenges identified by providers were at multiple levels -- structural, clinic, and individual and included: [1] access to care, [2] supply-chain issues, [3] identification and screening of child contacts, and [4] adherence to isoniazid preventive therapy. Conclusions Given the significant burden of TB morbidity and mortality in young children and the recent requirement by the WHO to report IPT initiation in child contacts, prioritization of child TB contact management is imperative and should include enhanced provider training on childhood TB and mentorship as well as strategies to eliminate challenges. Strategies that enable more efficient child TB contact management delivery include creating standardized tools that facilitate the implementation, tracking, and monitoring of child TB contact management coupled with guidance and mentorship from the district health management team. To tackle access to care challenges, we propose delivering intensive community health education, conducting community screening more efficiently using standardized tools, and facilitating access to services in the community.http://link.springer.com/article/10.1186/s12913-020-05324-0TuberculosisChild TB contact managementIsoniazid preventive therapyQualitative evaluation |
| spellingShingle | Yael Hirsch-Moverman Joanne E. Mantell Limakatso Lebelo Andrea A. Howard Anneke C. Hesseling Sharon Nachman Koen Frederix Llang Bridget Maama Wafaa M. El-Sadr Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study BMC Health Services Research Tuberculosis Child TB contact management Isoniazid preventive therapy Qualitative evaluation |
| title | Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study |
| title_full | Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study |
| title_fullStr | Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study |
| title_full_unstemmed | Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study |
| title_short | Provider attitudes about childhood tuberculosis prevention in Lesotho: a qualitative study |
| title_sort | provider attitudes about childhood tuberculosis prevention in lesotho a qualitative study |
| topic | Tuberculosis Child TB contact management Isoniazid preventive therapy Qualitative evaluation |
| url | http://link.springer.com/article/10.1186/s12913-020-05324-0 |
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