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Research article
Mojisola Oluwasanu
College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7186-1113
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This work is licensed under a CC BY 4.0 License. Read Full License
Tuberculosis is the world’s deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria.
This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary and tertiary healthcare facilities in two TB high burden states. Data was collected using key informant interviews, facility assessment using a semi-structured tool adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions.
The domain score for basic amenities in both states is 48.8% (SE:2.8); 47.0% (SE:4.0) in Anambra and 50.8% (SE:3.9) in Oyo state. In Oyo, only half of the facilities (50%) have access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states is 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (P = 0.56). The domain score for availability of staff and TB guidelines is 57.1% (SE:3.4) for both states. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states is 75%; this is higher in Oyo state (P = 0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing and gaps with continuing education on TB management.
The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.
Keywords
Service readiness, Health systems, Tuberculosis, Health workers, Human resources for health
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CURRENT STATUS: Published
View the published article at BMC Health Services Research.
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Editorial decision: Accept
On 03 Aug, 2020
Editor assigned
On 27 Jul, 2020
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On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 22 Jul, 2020
Editor assigned
On 02 Jul, 2020
Submission checks complete
On 01 Jul, 2020
Editor invited
On 01 Jul, 2020
Version 1
Posted 20 May, 2020
No comments provided
Review #2 received
Received 17 Jun, 2020
Editorial decision: Major revision
On 17 Jun, 2020
Review #1 received
Received 01 Jun, 2020
Reviewer #2 agreed
On 12 May, 2020
Reviewers invited
Invitations sent on 08 Apr, 2020
Reviewer #1 agreed
On 08 Apr, 2020
First submitted
On 25 Mar, 2020
Editor assigned
On 25 Mar, 2020
Submission checks complete
On 24 Mar, 2020
Editor invited
On 24 Mar, 2020
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See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Mojisola Oluwasanu
College of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7186-1113
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Editorial decision: Accept
On 03 Aug, 2020
Editor assigned
On 27 Jul, 2020
Submission checks complete
On 26 Jul, 2020
Editor invited
On 26 Jul, 2020
No comments provided
Editorial decision: Minor revision
On 22 Jul, 2020
Editor assigned
On 02 Jul, 2020
Submission checks complete
On 01 Jul, 2020
Editor invited
On 01 Jul, 2020
Version 1
Posted 20 May, 2020
No comments provided
Review #2 received
Received 17 Jun, 2020
Editorial decision: Major revision
On 17 Jun, 2020
Review #1 received
Received 01 Jun, 2020
Reviewer #2 agreed
On 12 May, 2020
Reviewers invited
Invitations sent on 08 Apr, 2020
Reviewer #1 agreed
On 08 Apr, 2020
First submitted
On 25 Mar, 2020
Editor assigned
On 25 Mar, 2020
Submission checks complete
On 24 Mar, 2020
Editor invited
On 24 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Tuberculosis is the world’s deadliest infectious disease and a leading cause of death in Nigeria. The availability of a functional healthcare system is critical for effective TB service delivery and attainment of national and global targets. This study was designed to assess readiness for TB service delivery in Oyo and Anambra states of Nigeria.
This was a facility-based study with a mixed-methods convergent parallel design. A multi-stage sampling technique was used to select 42 primary, secondary and tertiary healthcare facilities in two TB high burden states. Data was collected using key informant interviews, facility assessment using a semi-structured tool adapted from the WHO Service Availability and Readiness Assessment tool and facility observation using a checklist. Quantitative data were analysed using descriptive and inferential statistics while qualitative data were transcribed and analysed thematically. Data from both sources were integrated to generate conclusions.
The domain score for basic amenities in both states is 48.8% (SE:2.8); 47.0% (SE:4.0) in Anambra and 50.8% (SE:3.9) in Oyo state. In Oyo, only half of the facilities (50%) have access to constant power supply compared to 72.7% in Anambra state. The overall general service readiness index for both states is 69.2% with Oyo state having a higher value (73.3%) compared to Anambra with 65.4% (P = 0.56). The domain score for availability of staff and TB guidelines is 57.1% (SE:3.4) for both states. Indicators of this domain with very low values were staff training for the management of HIV and TB co-infection and training on MDR -TB. Almost half (47.6%) experienced a stock out of TB drugs in the 3 months preceding the study. The overall tuberculosis-specific service readiness index for both states is 75%; this is higher in Oyo state (P = 0.14). Qualitative data revealed areas of deficiencies for TB service delivery such as inadequate infrastructure, poor staffing and gaps with continuing education on TB management.
The weak health system remains a challenge and there must be concerted actions and funding by the government and donors to improve the TB healthcare systems.
Figure 1
Figure 2
Figure 3
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