Geographic Accessibility, Readiness, and Barriers of Health Facilities to Offer Tuberculosis Services in East Gojjam Zone, Ethiopia: A Convergent Parallel Design

• Main Authors: Asemahagn MA, Alene GD, Yimer SA
• Format: Article in Journal/Newspaper
• Language: English
• Published: Dove Medical Press 2020
• Subjects: accessibility; readiness; barriers; health facilities; tb services; ethiopia; Arctic medicine. Tropical medicine; RC955-962; Arctic; Norway
• Online Access: https://doaj.org/article/ca1cfa7a1d9646d9a8d794d24016db6f

Mulusew Andualem Asemahagn,1 Getu Degu Alene,1 Solomon Abebe Yimer2,3 1School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia; 2Department of Microbiology, Unit for Genome Dynamics, Faculty of Medicine, University of Oslo, Oslo, Norway; 3Coalition for Epidemic Preparedness Innovations (CEPI), Oslo, NorwayCorrespondence: Mulusew Andualem Asemahagn Email [e-mail]: Tuberculosis (TB) remains a foremost global public health threat. Active TB control needs geographically accessible health facilities that have quality diagnostics, equipment, supplies, medicines, and staff.Objective: This study aimed at assessing the geographic distribution, physical accessibility, readiness and barriers of health facilities for TB services in East Gojjam zone, Ethiopia.Methods: A convergent parallel design was applied using health facility and geographic data. Data on facility attributes, service availability and readiness were collected by inteviewing TB officers, laboratory heads and onsite facility visits. Coordinates of health facilities and kebele centroids were collected by GPS. We used ArcGIS 10.6 to measure Euclidean distance from each kebele centroids to the nearest health facility. Descriptive statistics were computed by using SPSS version 25. Barriers to TB service readiness were explored by in-depth interviews. NVivo12 was used to thematically analyze the qualitative data.Results: The overall TB health service coverage (THSC) was 23% (ranging: 10– 85%). The mean distance from the nearest health facility was 8km (ranging: 0.5– 16km). About 132 (32%) kebeles had poor geographic accessibility to TB services (over 10km distance from the nearest health facility) and had poor facility readiness. Although 114 (95%) health facilities offered at least one TB service, 44 (38.6%) of them had no sputum smear microscopy. The overall TB readiness index was 63.5%: first-line anti-TB drugs (97%), diagnostics (63%), trained staffs, diagnostic and treatment guidelines ...