Explaining the successes and failures of tuberculosis treatment programs; a tale of two regions in rural eastern Uganda
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
BMC health services research
Abstract
Optimally performing tuberculosis (TB) programs are characterized by treatment success rate (TSR) of
at least 90%. In rural eastern Uganda, and elsewhere in sub Saharan Africa, TSR varies considerably across district TB
programs and the reasons for the differences are unclear. This study explored factors associated with the low and
high TSR across four districts in rural eastern Uganda.We interviewed District TB and Leprosy Supervisors, Laboratory focal persons, and health facility TB focalpersons from four districts in eastern Uganda as key informants. Interviews were audio recorded, transcribed
verbatim, and imported into ATLAs.ti where thematic content analysis was performed and results were summarized
into themes.
The emerging themes were categorized as either facilitators of or barriers to treatment success. The emerging facilitators prevailing in the districts with high rates of treatment success were using data to make
decisions and design interventions, continuous quality improvement, capacity building, and prioritization of better
management of people with TB. The barriers common in districts with low rates of treatment success included lack
of motivated and dedicated TB focal persons, scarce or no funding for implementing TB activities, and a poor
implementation of community-based directly observed therapy short course.This study shows that several factors are associated with the differing rates of treatment success in
rural eastern Uganda. These factors should be the focus for TB control programs in Uganda and similar settings in
order to improve rates of treatment success.
Description
Keywords
Barriers, Facilitators, Health systems strengthening, Treatment success, Tuberculosis, Uganda
Citation
Izudi, J., Tamwesigire, I. K., & Bajunirwe, F. (2019). Explaining the successes and failures of tuberculosis treatment programs; a tale of two regions in rural eastern Uganda. BMC health services research, 19(1), 1-10. https://doi.org/10.1186/s12913-019-4834-2