Factors affecting implementation of community based directly observed treatment of tuberculosis, short course, in Hoima district - Uganda.
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A dissertation submitted to the School of Graduate Studies in partial fulfilment of the requirements for the award of the degree of Master of Public Health of Makerere University
Introduction: Tuberculosis is a communicable disease of human beings caused by Mycobacterium Tuberculosis bacteria. In CB-DOTS, tuberculosis patients are initially treated in a health centre by a health worker for two weeks before they are sent back to their communities to continue treatment, under supervision of a Community Volunteer. Objectives: The specific objectives of the study were: To establish patient related factors influencing implementation of CB-DOTS in Hoima district; to establish community related factors affecting CB-DOTS implementation in Hoima district; and to establish health system related factors affecting CB-DOTS implementation in Hoima districts Study design: This was a descriptive cross sectional study employing qualitative methods of data collection, intended to identify factors affecting implementation of CB-DOTS in Hoima district in 2003. Results: The findings of the study show that not having a community volunteer, long waiting time at the health unit, distance of over 5km from the health unit, and use of other drugs in addition to the anti-TB drugs provided at the health unit, affect implementation of CB-DOTS. Tuberculosis patients who had community volunteers and those who did not experience stock-outs of anti-TB drugs at the health unit of treatment were more likely to have completed treatment. CB-DOTS patients who collect anti-TB drugs themselves from the Sub-county Health Worker were more likely not to complete treatment. Recommendations: From the findings of the study it is recommended that community volunteers be trained before they begin to serve the communities, the district should ensure adequate supplies of anti-TB drugs and diagnostic materials at all TB treatment centers. It is further recommended that community members and HWs be sensitized on CB-DOTS and on how to humanely handle TB patients respectively. Traditional healers should also be integrated into TB care.
Introduction: Tuberculosis is a communicable disease of human beings caused by Mycobacterium Tuberculosis bacteria. In CB-DOTS, tuberculosis patients are initially treated in a health centre by a health worker for two weeks before they are sent back to their communities to continue treatment, under supervision of a Community Volunteer. Objectives: The specific objectives of the study were: To establish patient related factors influencing implementation of CB-DOTS in Hoima district; to establish community related factors affecting CB-DOTS implementation in Hoima district; and to establish health system related factors affecting CB-DOTS implementation in Hoima districts Study design: This was a descriptive cross sectional study employing qualitative methods of data collection, intended to identify factors affecting implementation of CB-DOTS in Hoima district in 2003. Results: The findings of the study show that not having a community volunteer, long waiting time at the health unit, distance of over 5km from the health unit, and use of other drugs in addition to the anti-TB drugs provided at the health unit, affect implementation of CB-DOTS. Tuberculosis patients who had community volunteers and those who did not experience stock-outs of anti-TB drugs at the health unit of treatment were more likely to have completed treatment. CB-DOTS patients who collect anti-TB drugs themselves from the Sub-county Health Worker were more likely not to complete treatment. Recommendations: From the findings of the study it is recommended that community volunteers be trained before they begin to serve the communities, the district should ensure adequate supplies of anti-TB drugs and diagnostic materials at all TB treatment centers. It is further recommended that community members and HWs be sensitized on CB-DOTS and on how to humanely handle TB patients respectively. Traditional healers should also be integrated into TB care.
Keywords
Community health care, Tuberculosis treatment, Uganda Hoima district Communicable diseases, CB-DOTS