TITLE:
Implementation of Tuberculosis and Human Immune-Deficiency Virus Programs Collaborative Services in Public-Private Mix Direct Observed Therapy Short Course Facilities in Addis Ababa, Ethiopia: Cross Sectional Facility Based Mixed Method
AUTHORS:
Lakew Huluka Bahiru, Mesele Damte Argaw, Maeza Demissie
KEYWORDS:
Tuberculosis, Human Immune-Deficiency Virus, Implementation, Collaborative, Predictors, Public Private Mix, Ethiopia
JOURNAL NAME:
Open Journal of Epidemiology,
Vol.6 No.2,
May
13,
2016
ABSTRACT: Background: Ethiopia is one of the
countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis
(TB) infection rates in the world. To improve TB/HIV Programs outcomes through
Public Private Partnership Mix (PPM) approach was in place since 2006. But the
status of its implementation has never been assessed. Methods: In this cross
sectional study we employed mixed methods; we interviewed 272 tuberculosis
patients, reviewed their records, and facilitated six in-depth interviews and
four focus group discussions. The survey was conducted from January through
March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and
the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV
counseling for all TB patients; whereas 87.5% of TB patients have received HIV
testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV
patients were enrolled into chronic disease care services, 64.8% were put on
Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly
active anti-retro viral therapy (HAART) services. All PPM facilities don’t have
IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly
linked with the public health sector which was documented by developing inclusive
work plan which create access to supplies and conducting joint supportive
supervisions. However, the majorities of PPM facilities don’t have
Multi-Disciplinary Team and lacks some essential supplies. The predictor for
uptake of CPT were: being females TB patients was 86% lower than their counter
part males (AOR = 0.14; 95% CI = 0.04 - 0.92 P = 0.002), patients who has
attended their TB/HIV care at private for the profit facilities were 84% lower
than those attend in private not for profit facilities (AOR = 0.16; 95% CI =
0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at
program level are stronger but only half of patients didn’t get the
comprehensive TB/HIV collaborative services to achieve recommended quality of
care. Strengthening the services and ensuring the availability of essential
supplies was highly recommended.