Evaluation of quality of tuberculosis laboratory service at public health centers of jimma town, southwest Ethiopia

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.