Patients and Health System-Related Factors Impacting on Tuberculosis Program Implementation in Resource-Constrained Settings: Experience from Multi-TB Facilities in Oyo State, South-West of Nigeria

Abstract

Background : Tuberculosis (TB) is one of the most prevalent human infections and is the second leading cause of deaths from infectious diseases worldwide, and Nigeria is the fourth among the 22 high-burden countries in the world for tuberculosis even though the exact burden of TB in Nigeria is not known. Methods : The study used exploratory cross-sectional design. A multistage stratified ran - dom sampling technique was used to select 680 participants from 16 DOTS facilities in one state in Nigeria. Results : The results show that 59.25% (410) of individuals believed that the quality of access to care was excellent, 78.44% (542) of individuals believed that the appearance of the healthcare facility they attended was excellent, 75.40% (518) of individuals believed that there were many people accessing healthcare facilities and 82.33% (559) reported that they waited less than 30 minutes at a healthcare facility. Conclusions : Providing good was generally satisfactory. Findings from this study are relevant for policy formation and strategic implementation for TB control program in resource-limited settings. its association with HIV), health literacy (TB-related knowledge and education) and sociocultural (gender roles and status in the family) factors, whereas provider-/system-level barriers include provider’s degree of suspicion for TB, the number and types of providers seen before TB diagnosis, provider adherence to national TB program guidelines and patient satisfaction with TB services [2, 6, 7]. Due to these challenges, a comprehensive understand-ing of barriers is needed in order to provide insight into TB service programs, research and policy. It is against this background that this study was designed to determine individual and provider’s barriers and delays that limit access and adherence to TB services.