Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study
Abstract Background Decreasing the burden of Tuberculosis (TB) among PLHIV through TB screening is an effective intervention recommended by the World Health Organization (WHO). However, after over a decade of implementation in Ghana, the intervention does not realize the expected outcomes. It is als...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08295-6 |
| _version_ | 1818510737853644800 |
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| author | Solomon A. Narh-Bana Mary Kawonga Selase Adjoa Odopey Frank Bonsu Latifat Ibisomi Tobias F. Chirwa |
| author_facet | Solomon A. Narh-Bana Mary Kawonga Selase Adjoa Odopey Frank Bonsu Latifat Ibisomi Tobias F. Chirwa |
| author_sort | Solomon A. Narh-Bana |
| collection | DOAJ |
| description | Abstract Background Decreasing the burden of Tuberculosis (TB) among PLHIV through TB screening is an effective intervention recommended by the World Health Organization (WHO). However, after over a decade of implementation in Ghana, the intervention does not realize the expected outcomes. It is also not well understood whether this lack of success is due to implementation barriers. Our study, therefore, sought to examine the factors influencing the implementation of the intervention among people living with HIV (PLHIV) attending HIV clinics at district hospitals in Ghana. Methods This was a qualitative study conducted from 6th to 31 May 2019 in three regions of Ghana. We conducted 17 in-depth interviews (IDIs – comprising two regional, six districts and nine facility TB/HIV coordinators) and eight focus group discussions (FGD – consisting of a total of 65 participants) with HIV care providers. The Consolidated Framework for Implementation Research (CFIR) guided the design of interview guides, data collection and analysis. All responses were digitally audio-recorded and transcribed verbatim for coding and analysis using the Framework Approach. Participants consented to the interview and recording. Results The main barriers to TB screening relate to the low commitment of the implementers to screen for TB and limited facility infrastructure for the screening activities. Facilitators of TB screening include (1) ease in TB screening, (2) good communication and referral channels, (3) effective goals and feedback mechanisms, (4) health workers recognizing the need for the intervention and (5) the role of chemical sellers. Conclusions Key barriers and facilitators to the intervention are revealed. The study has shown that there is a need to increase HIV care providers and institutional commitment towards TB screening interventions. In addition, cost issues need to be assessed as they are drivers of sustainability. Our study also advances the field of implementation science through CFIR to better understand the factors influencing the implementation. |
| first_indexed | 2024-12-10T23:24:09Z |
| format | Article |
| id | doaj.art-8aef15ad2b024f8cb34db83acb3bd7fa |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-10T23:24:09Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-8aef15ad2b024f8cb34db83acb3bd7fa2022-12-22T01:29:38ZengBMCBMC Health Services Research1472-69632022-07-0122111210.1186/s12913-022-08295-6Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative studySolomon A. Narh-Bana0Mary Kawonga1Selase Adjoa Odopey2Frank Bonsu3Latifat Ibisomi4Tobias F. Chirwa5School of Public Health, Faculty of Health Sciences, University of the WitwatersrandSchool of Public Health, Faculty of Health Sciences, University of the WitwatersrandDodowa Health Research Centre, Research and Development Division, Ghana Health ServiceNational TB Control ProgrammeSchool of Public Health, Faculty of Health Sciences, University of the WitwatersrandSchool of Public Health, Faculty of Health Sciences, University of the WitwatersrandAbstract Background Decreasing the burden of Tuberculosis (TB) among PLHIV through TB screening is an effective intervention recommended by the World Health Organization (WHO). However, after over a decade of implementation in Ghana, the intervention does not realize the expected outcomes. It is also not well understood whether this lack of success is due to implementation barriers. Our study, therefore, sought to examine the factors influencing the implementation of the intervention among people living with HIV (PLHIV) attending HIV clinics at district hospitals in Ghana. Methods This was a qualitative study conducted from 6th to 31 May 2019 in three regions of Ghana. We conducted 17 in-depth interviews (IDIs – comprising two regional, six districts and nine facility TB/HIV coordinators) and eight focus group discussions (FGD – consisting of a total of 65 participants) with HIV care providers. The Consolidated Framework for Implementation Research (CFIR) guided the design of interview guides, data collection and analysis. All responses were digitally audio-recorded and transcribed verbatim for coding and analysis using the Framework Approach. Participants consented to the interview and recording. Results The main barriers to TB screening relate to the low commitment of the implementers to screen for TB and limited facility infrastructure for the screening activities. Facilitators of TB screening include (1) ease in TB screening, (2) good communication and referral channels, (3) effective goals and feedback mechanisms, (4) health workers recognizing the need for the intervention and (5) the role of chemical sellers. Conclusions Key barriers and facilitators to the intervention are revealed. The study has shown that there is a need to increase HIV care providers and institutional commitment towards TB screening interventions. In addition, cost issues need to be assessed as they are drivers of sustainability. Our study also advances the field of implementation science through CFIR to better understand the factors influencing the implementation.https://doi.org/10.1186/s12913-022-08295-6BarriersEnablersFactorsTB screeningPLHIVGhana |
| spellingShingle | Solomon A. Narh-Bana Mary Kawonga Selase Adjoa Odopey Frank Bonsu Latifat Ibisomi Tobias F. Chirwa Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study BMC Health Services Research Barriers Enablers Factors TB screening PLHIV Ghana |
| title | Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study |
| title_full | Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study |
| title_fullStr | Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study |
| title_full_unstemmed | Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study |
| title_short | Factors influencing the implementation of TB screening among PLHIV in selected HIV clinics in Ghana: a qualitative study |
| title_sort | factors influencing the implementation of tb screening among plhiv in selected hiv clinics in ghana a qualitative study |
| topic | Barriers Enablers Factors TB screening PLHIV Ghana |
| url | https://doi.org/10.1186/s12913-022-08295-6 |
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