Healthcare Worker Preferences for Active Tuberculosis Case Finding Programs in South Africa: A Best-Worst Scaling Choice Experiment

IntroductionBest–worst scaling (BWS) is becoming increasingly popular to elicit preferences in health care. However, little is known about current practice and trends in the use of BWS in health care. This study aimed to identify, review and critically appraise BWS in health care, and to identify trends over time in key aspects of BWS.MethodsA systematic review was conducted, using Medline (via Pubmed) and EMBASE to identify all English-language BWS studies published up until April 2016. Using a predefined extraction form, two reviewers independently selected articles and critically appraised the study quality, using the Purpose, Respondents, Explanation, Findings, Significance (PREFS) checklist. Trends over time periods (≤2010, 2011, 2012, 2013, 2014 and 2015) were assessed further.ResultsA total of 62 BWS studies were identified, of which 26 were BWS object case studies, 29 were BWS profile case studies and seven were BWS multi-profile case studies. About two thirds of the studies were performed in the last 2 years. Decreasing sample sizes and decreasing numbers of factors in BWS object case studies, as well as use of less complicated analytical methods, were observed in recent studies. The quality of the BWS studies was generally acceptable according to the PREFS checklist, except that most studies did not indicate whether the responders were similar to the non-responders.ConclusionUse of BWS object case and BWS profile case has drastically increased in health care, especially in the last 2 years. In contrast with previous discrete-choice experiment reviews, there is increasing use of less sophisticated analytical methods.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-016-0429-5) contains supplementary material, which is available to authorized users.

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“…[78]Australia20153110324111115 O’Hara et al. [79]South Africa201512515125101114 Ratcliffe et al. [80]Australia2015119045109101002 Tsao et al.…”

Section: Resultsmentioning

confidence: 99%

Using Best–Worst Scaling to Investigate Preferences in Health Care

et al. 2016

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“…On the other hand, facilitators in health systems are patient nancial support, quick testing time, appropriate counseling and testing, patient tracking, health worker training, quick and e cient work ows, su cient sta ng, free and con dential TB services [40,41,44,46,47,[59][60][61].…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Meta-Synthesis of Facilitators and Barriers to Tuberculosis Diagnosis and Treatment in Nigeria

Oga‐Omenka

Wakdet

Menzies

et al. 2020

Preprint

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Background Despite progress in tuberculosis (TB) control globally, TB continues to be a leading cause of death from infectious diseases, claiming 1.2 million lives in 2018; 214,000 of these deaths were due to drug resistant strains. Of the estimated 10 million cases globally in 2018, 24% were in Africa, with Nigeria and South Africa making up most of these numbers.Nigeria ranks 6th in the world for TB burden, with an estimated 4.3% multi-drug resistance in new cases. However, the country had one of the lowest case detection rates, estimated at 24% of incident cases in 2018 - well below the World Health Organization (WHO) STOP TB target of 84%. This rate highlights the need to understand contextual issues influencing tuberculosis management in Nigeria. Our synthesis was aimed at synthesizing qualitative evidence on factors influencing TB care in Nigeria.Methods A three-stage thematic meta-synthesis of qualitative studies was used to identify barriers and facilitators to tuberculosis case finding and treatment in Nigeria. A purposive search of eleven databases was conducted. The date of publication was limited to 2006 to June 2020. We analyzed articles using a three-stage process, resulting in coding, descriptive subthemes and analytical themes.Results Our final synthesis of 10 articles resulted in several categories including community and family involvement, education and knowledge, attitudes and stigma, alternative care options, health system factors (including coverage and human resource), gender, and direct and indirect cost of care. These were grouped into three major themes: individual factors; interpersonal influences; and health system factors.Conclusion Case finding and treatment for TB in Nigeria currently depends more on individual patients presenting voluntarily to the hospital for care, necessitating an understanding of patient behaviors towards TB diagnosis and treatment. Our synthesis has identified several related factors that shape patients’ behavior towards TB management at individual, community and health system levels that can inform future interventions.

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“…As we were the ones most directly involved with all the components of the research -from the formation of the collaboration, to planning the research agenda and designing the projects, to collecting and analyzing the data and synthesizing results for decision-makers and scholarly venuesour own perceptions, synthesized through the process of writing this article, provided the main source of data. The description was aided by reference to the over 10 publications already published from our collaboration [20,[43][44][45][46][47][48][49][50][51][52].…”

Section: Data Collection and Analysismentioning

confidence: 99%

“…This study included 2 focus groups, key informant interviews, and distribution of a questionnaire at two hospitals in Free State. Analysis of results found that to improve uptake of TB screening by health workers, programs should be free, guaranteed, confidential, with minimal waiting times, and available at the workplace [52].…”

Section: Contextualizing Why and How The Canadian-south African Partnmentioning

confidence: 99%

Protecting health workers from infectious disease transmission: an exploration of a Canadian-South African partnership of partnerships

et al. 2016

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BackgroundHealth workers are at high risk of acquiring infectious diseases at work, especially in low and middle-income countries (LMIC) with critical health human resource deficiencies and limited implementation of occupational health and infection control measures. Amidst increasing interest in international partnerships to address such issues, how best to develop such collaborations is being actively debated. In 2006, a partnership developed between occupational health and infection control experts in Canada and institutions in South Africa (including an institute with a national mandate to conduct research and provide guidance to protect health workers from infectious diseases and promote improved working conditions). This article describes the collaboration, analyzes the determinants of success and shares lessons learned.MethodsSynthesizing participant-observer experience from over 9 years of collaboration and 10 studies already published from this work, we applied a realist review analysis to describe the various achievements at global, national, provincial and hospital levels. Expectations of the various parties on developing new insights, providing training, and addressing service needs were examined through a micro-meso-macro lens, focusing on how each main partner organization contributed to and benefitted from working together.ResultsA state-of-the-art occupational health and safety surveillance program was established in South Africa following successful technology transfer from a similar undertaking in Canada and training was conducted that synergistically benefitted Northern as well as Southern trainees. Integrated policies combining infection control and occupational health to prevent and control infectious disease transmission among health workers were also launched. Having a national (South-South) network reinforced by the international (North–south) partnership was pivotal in mitigating the challenges that emerged.ConclusionsHigh-income country partnerships with experience in health system strengthening – particularly in much needed areas such as occupational health and infection control – can effectively work through strong collaborators in the Global South to build capacity. Partnerships are particularly well positioned to sustainably reinforce efforts at national and sub-national LMIC levels when they adopt a “communities of practice” model, characterized by multi-directional learning. The principles of effective collaboration learned in this “partnership of partnerships” to improve working conditions for health workers can be applied to other areas where health system strengthening is needed.

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Healthcare Worker Preferences for Active Tuberculosis Case Finding Programs in South Africa: A Best-Worst Scaling Choice Experiment

Cited by 19 publications

References 31 publications

Using Best–Worst Scaling to Investigate Preferences in Health Care

Using Best–Worst Scaling to Investigate Preferences in Health Care

A Qualitative Meta-Synthesis of Facilitators and Barriers to Tuberculosis Diagnosis and Treatment in Nigeria

Protecting health workers from infectious disease transmission: an exploration of a Canadian-South African partnership of partnerships

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