Evaluation of Multi-Drug Resistant Tuberculosis Treatment Services’ Quality in St, Peter Specialized Hospital Addis Ababa, Ethiopia

Abstract

Background; -. The emergence of drug-resistant tuberculosis is currently a challenge for the End- TB strategy. Globally in 2018 alone, there were about three hundred ninety thousand new cases of Multidrug-resistant tuberculosis (MDR-TB The MDR-TB treatment success rate of St. Peter Specialized Hospital is in a decreasing pattern. Furthermore , Delay to initiate the chemotherapy after diagnosis is noticed. However, the reason is not assessed from a holistic perspective yet. Objective; - To assess the quality of Multi-Drug Resistant Tuberculosis treatment service in St. Peter specialized hospital, Ethiopia, 2020. Methods and Materials; - The formative evaluation was conducted from April 1to April 21 2020 by applying the Donabedian framework for quality assessment in St. Peter specialized hospital. A single case study design was selected. It was assessed based on availability, compliance, Interim clinical outcome, and satisfaction dimensions. Moreover, twenty provider-patient interactions observation, thirteen Key informant interviews, and all patient charts for the last two years reviewed, and all patients currently on treatment were interviewed. The inventory and chart review checklists were taken from the national guideline. The observation and interview tools were adapted from different literatures. Thematic analysis technique was applied for the qualitative data. And for the quantitate data, Descriptive summary and principal component analysis were done by SPSS 25. Result: - The evaluation finding indicate resource availability scores of 77.7%. The absence of culture laboratory, shortage of training for the staff were the identified gaps. And interrupted supply of plumpy-nut and chemistry test reagents were the uncovered problem. The compliance score was 68%. Baseline and follow up physical examinations were done only for less than half(48.5%) of the patients. Only 31.4% of patients had a second-line drug sensitivity test. There was no supportive supervision in the last six months. The social support covers 65% of the eligible clients. The interim clinical outcome scores 88%. Whereas, the overall satisfaction score with multidrug-resistant TB is 75.6%. The overall quality based on the judgment parameter was good. Conclusion and Recommendation: - Interruptions of Ready To use therapeutic food supply, laboratory reagent should be managed by the hospital. The culture laboratory should be finished. Provision of social support, on-job training and supportive supervision with written timely feedback should be improved by the Ministry of Health.