Assessment of Feasibility of Implementing Dots in Private Health Facilities in Addis Ababa, Ethiopia
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Date
2006-06
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Addis Abeba Universty
Abstract
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).
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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.
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Assessment of Feasibility of Implementing