Quality of Directly Observed Treatment Strategy of Tuberculosis in Public Health Facilities in Dessie City Administrative Zone, Amhara Region, Northeast Ethiopia

Abstract

Background: Quality of care is an important aspect of health care system that is given a priority especially providing quality of care for tuberculosis patient is crucial in prevention and control of disease. Despite highly effective anti TB agents for tuberculosis treatment, its burden was not decreased because of the emergence of fabricated epidemic of MDR-TB. Responses to this emergency cannot be achieved without adequate focus on improving quality of care. Objective: To assess the quality of directly observed Treatment strategy of Tuberculosis in public health facilities of Dessie city administrative zone, Amhara Regional State. Methods: The study was conducted at Dessie city administrative zone in eight public health facilities using a cross-sectional study design from June to July 2013.The sample size of 112 TB patients and 295 patients' records were selected with simple and systematic random sampling technique. Pretested questionnaires were used to collect data. Data was checked, entered and analyzed using SPSS version 16.0 software. Logistic regression analysis was used to identify the effect of explanatory variable on the outcome variable. Variables, which showed association in multivariate analysis was considered as final predictors. Ethical clearance was obtained from Jimma University and the official letter was delivered to Dessie City administrative zone health department. Results: The study shows only 24 % of the tuberculosis treatment service is achieved from expected and 53.7% were satisfied. Staff refreshing training and supportive supervision are neglected issue. Statically significant associations were observed between treatment success rate with conformity to drug regimens during intensive (AOR=0.04, 95% CI: 0.01, 0.91) & continuation phase (AOR=0.05 95% CI: 0.01, 0.5) of therapy smear adherence (AOR=10.42, 95% CI: 1.33, 81.46). Patents' sex (AOR=0.13, 95% CI: 0.03, 0.49), distance from health facilities, (AOR=0.20, 95% CI: 0.05, 0.76) waiting time to get clinician (AOR=0.10, 95% CI: 0.02, 0.43), availability of prescribed drugs and other related services (AOR=0.20, 95% CI: 0.06, 0.68) and being respected at time of treatment (AOR=0.1395% CI: 0.02, 0.48) were final predictors of patients' satisfaction. Conclusion: The overall tuberculosis treatment service status in all dimensions is poor. The care settings do not have sufficient amount of supplies and materials. Care providers are loosely adhered to national TB treatment protocol. The dimensions of outcome quality indicators are not "satisfactory". All program coordinators and care providers at different levels should act accordingly to resolve weakness in all quality dimensions.