Assessment of Feasibility of Implementing Dots in Private Health Facilities in Addis Ababa, Ethiopia

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Addis Abeba Universty


Introduction: The MDG of reducing deaths from TB can be achieved, if TB control efforts approach as closely as possible the global goals for case detection of smear positive PTB (70%) and cure rate of 85% or above. Currently Ethiopia’s case detection rate stands 36% since the year 2002, and unless the current efforts are intensified with innovative approaches, such as the involvement of private health care providers in the service delivery, the government with its limited resources can't reach the target set by MDG regarding TB control. Before directly embarking to the new approach, a baseline assessment of private health facilities capacity and willingness to collaborate in TB control programme is of paramount importance. Objective: to assess feasibility of implementing DOTS in private health facilities in Addis Ababa. More specifically to assess willingness of private health facility managers, to asses staffs' knowledge, current practices in diagnosis, treatment and referral of Tuberculosis, and to assess private health facilities’ institutional capacity to provide comprehensive tuberculosis prevention and control services. Methodology: An institution based, cross sectional descriptive study was carried out from November 2005 to June 2006. Feasibility of implementing DOTS was assessed using a structured and pre tested interviewer administered questionnaire and observation checklist to collect the necessary information. A total of 96 health facilities, 96 respondents in charge of the health facilities and 162 health workers were participated in the study. Data were analyzed using SPSS version 10.1 statistical package. Frequency distribution and percentages were used to present findings. Stepwise aggregation of composite variables and their scores to reach to decision for feasibility were used. Feasibility status was rated as poor, fair, good, very good and excellent based on the attained composite score for the indicator variables. Result: The composite score calculated for willingness to implement DOTS is fair (52.1), general TB knowledge is very good (73.1). Structural capacity, availability of basic laboratory materials, general TB related practice and manpower as DOTS center were good with 67.3, 63.9, 61.0, and 60.7 scores respectively, resulting the over all feasibility status good (63.0). xi Conclusion: Implementation of DOTS in private health facilities is feasible, given appropriate DOTS training, technical assistance and supervision. Piloting of the project in limited areas and appropriate facilities is recommended.



Assessment of Feasibility of Implementing