National TB program shortages as potential factor for poor-quality TB care cascade: Healthcare workers’ perspective from Beira, Mozambique

Abstract

Background Mozambique is one of the countries with the deadly implementation gaps in the tuberculosis (TB) care and services delivery. In-hospital delays in TB diagnosis and treatment, transmission and mortality still persist, in part, due to poor-quality of TB care cascade. Objective We aimed to assess, from the healthcare workers' (HCW) perspective, factors associated with poor-quality TB care cascade and explore local sustainable suggestions to improve inhospital TB management. Methods In-depth interviews and focus group discussions were conducted with different categories of HCW. Audio-recording and written notes were taken, and content analysis was performed through atlas.ti7. Results Bottlenecks within hospital TB care cascade, lack of TB staff and task shifting, centralized and limited time of TB laboratory services, and fear of healthcare workers getting infected by TB were mentioned to be the main factors associated with implementation gaps. Interviewees believe that task shifting from nurses to hospital auxiliary workers, and from higher and well-trained to lower HCW are accepted and feasible. The expansion and use of molecular TB diagnostic tools are seen by the interviewees as a proper way to fight effectively against both sensitive and MDR TB. Ensuring provision of N95 respiratory masks is believed to be an essential requirement for effective engagement of the HCW on high-quality in-hospital PLOS ONE |

Barriers to tuberculosis case finding in primary and secondary health facilities in Ghana: perceptions, experiences and practices of healthcare workers

“…The main health system-related barrier was that the TB diagnostic laboratory was at the municipal hospital which is distant from most rural health facilities, and clients cannot afford the transport cost [ 18 ]. Limited access to diagnostic facilities, mostly in rural settings, and long travel distance were similar barriers experienced by presumed TB clients in other parts of the world [ 6 , 7 , 22 – 26 ]. The lack of a standard referral system in our rural study facilities also led to extended waiting times for some referred clients at the municipal hospital and this further underscored their reluctance to go to the municipal hospital for further assessment and testing.…”

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Predictors of unfavourable tuberculosis treatment outcome in Bilene District, Gaza Province, Mozambique: A retrospective analysis, 2016 - 2019

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Cascada de atención de la tuberculosis para la población indígena en Colombia: una investigación operativa

“…Un estudio de la cascada de atención de la TB desde la perspectiva de los trabajadores de la salud en un entorno hospitalario indicó que la escasez de personal de enfermería tiene consecuencias negativas en la calidad de la atención (31). Lo anterior permite reflexionar que estas dificultades de los trabajadores de la salud son más marcadas en contextos de atención primaria de difícil acceso como en la presente investigación.…”