Abstract:
Background: The quality of Tuberculosis (TB) laboratory diagnosis in public health facilities is
a direct reflection of the success of TB control programs and a key compo0nent of the Directly
Observed Treatment Strategy (DOTS), yet it is one of the most neglected components of these
programs.
Evaluation objective: To evaluate the quality of TB laboratory services in public health centers
of Jimma town.
Method: The evaluation was conducted in Jimma town at four public health centers. A case
study design with mixed method was used from April 1 to 30, 2018. The focus of the evaluation
was process based on Donabedian structure-process–outcome model of health care quality with
formative evaluation approach. Dimensions of the evaluation were availability, compliance and
acceptability. By using structured questionnaire all 174 TB clients who were sent to laboratory
in the study period interviewed consecutively; 24 provider client interaction sessions observation
conducted, 174 NTP(National Tuberculosis Program) approved TB laboratory request papers
were reviewed and resource inventory was conducted using resource inventory checklist. Key
informant interview was conducted with eight laboratory professionals and one TB focal person
working in the town health office. Quantitative data was entered in to Epi Data version 3.1and
exported to SPSS version 20.0 for descriptive analysis. Qualitative data were transcribed,
translated, coded and analyzed in themes. The evaluation findings were interpreted based on
pre- determined judgment matrix. Findings were presented using descriptions, tables and
graphs.
Result: The result of this study showed that the overall quality of TB laboratory service
was79.76%.The structure, process and outcome quality were judged as good. According to the
judgmental parameter the resources availability was 88.3%, compliance was 83% and
satisfaction of TB clients was 68%..However, no isolated laboratory room, lack of checking the
quality of sputum sample, and higher proportions of clients were dissatisfied with lack of respect
from the providers and time for the result.
Conclusion and Recommendation: It was concluded that the three quality parameters as well as
the overall quality of TB laboratory service at four health centers was good in relative to the predetermined judgment criteria. But there were no isolated and ventilated laboratory rooms for TB
lab. Likewise a relatively higher proportion of patients were not satisfied with time spent to
receive the result. We recommend to concerned bodies to establish mechanisms to improve these.
