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Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia

Received: 23 June 2014     Accepted: 8 July 2014     Published: 30 July 2014
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Abstract

Background: Observing quality from the patient’s perspective is of paramount importance for making the service more responsive to patients. However, little is known about the quality of tuberculosis treatment service from the patient’s perspective in Ethiopia. This study was carried out to assess the quality of tuberculosis treatment services from the patient’s perspective in South Ethiopia’s public health facilities. Methods: A facility-based, cross-sectional study design was employed, and data were collected from February to March, 2012. A QUOTE-TB tool validated for East African countries was used to collect data from a sample of 370 tuberculosis patients receiving treatments at public health facilities. The study participants were allocated proportionally to the number of client receives the service, and the relative importance of the aspects and perception of the quality of their received care was scored. Combining the relative importance and actual performance scores derived a measure of service quality. Analyses were performed using SPSS and statistical significance was set at a p-value less than 0.05. Results: The accommodation aspects of the facilities, patient-provider interactions, health information and communication, and availability of care had low quality impact scores. The highest service quality scores were for TB-HIV integration and cost of treatment. Shorter waiting times (ß=-1.85), routine observation, and checking the daily TB drug intake (ß=-1.26) and treatment by the same health provider (ß=1.13) independently predicted overall patient satisfaction. Conclusion: There were notable differences between TB patients ‘expectations and what they actually received in terms of accommodation, availability, patient-provider interactions, health information, and communication, which were identified as being of inadequate quality. Significant effort is needed to improve the quality of TB care with respect to these particular aspects from the perspectives of patients. Individuals caring for patients with TB in the health service should address these areas of care in order to enhance TB treatment services and satisfy patients.

Published in American Journal of Nursing Science (Volume 3, Issue 4)
DOI 10.11648/j.ajns.20140304.12
Page(s) 48-55
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Tuberculosis, Quality of Treatment Service, Satisfaction

References
[1] World Health Organization: Implementing the Stop TB Strategy a Handbook for national Tuberculosis control programmes. Geneva: World Health Organization; 2008.
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[3] World Health Organization: Global tuberculosis control Report 2011. In.; 2011.
[4] JAN MAINZ: Defining and classifying clinical indicators for quality improvement. International Journal for Quality in Health Care 2003, 15(6):523–530.
[5] Federal Ministry of Health: Health Sector Strategic Plan (HSDP-III). In. Edited by Programming HPa, vol. 3. Addis Ababa: FMOH; 2009.
[6] Maher D, Blanc L, Raviglione M: WHO policies for tuberculosis control. Lancet 2004:363-1911.
[7] Federal Ministry of Health: Tuberculosis, Leprosy and TB/HIV Prevention and Control Programme Manual. In. Edited by Control THPa, 4 edn. Addis Ababa; 2008.
[8] Mengiste MM, James NN, John DW, Amanuel G, Tassew T, Frew L, and et’al: Quality of tuberculosis care and its association with patient adherence to treatment in eight Ethiopian districts. Health Policy and Planning 2009, 24:457–466.
[9] Borgdorff MW, Floyd K, Broekmans JF: Interventions to reduce tuberculosis mortality and transmission in low- and middle-income countries. Bull. World Health Organ. [PubMed: 11984608] 2002, 80(3):217–227.
[10] Shargie EB, Lindtjorn B: Determinants of treatment adherence among smear-positive tuberculosis patients in Southern Ethiopia. PLOS medicine PubMed 2007, 4:280-287.
[11] Jin BW, Kim SC, Mori T, Shimao T: The impact of intensified supervisory activities on tuberculosis treatment, Tubercle and Lung Disease 1993, 74:267–272.
[12] Ovretveit J: Health service quality: An introduction to quality methods for health services. London: Blackwell Scientific; 1992.
[13] Hadiya Zonl Health Department: Hadiya Zone Health Department anuual report In. Hossana; 2011.
[14] Birhanu Z, Assefa T, Woldie M, Morankar S: Determinants of satisfaction with health care provider interactions at health centres in central Ethiopia. BMC Health Services Research 2010, 13(74):1472-6963.
[15] Grant N, Marshall, Ron DH: The patient satisfaction Questionnaire short- form (PSQ-18), RAND, Santa Monica, CA. 1994.
[16] Tuberculosis Coalition for Technical Assistance, QUOTE TB. Guide for improving TB care as seen through the eyes of the patient. Amsterdam: Tuberculosis Coalition for Technical Assistance; 2007.
[17] Herman J, Sixma, Jan JK, Crétien vC, Peters L: Quality of care from the patients’ perspective: from theoretical concept to a new measuring instrument: Health Expectations; 1998.
[18] Girma A, H/Mariam D, Deribe K: Quality of tuberculosis care in six health facilities of Afar Region, Ethiopia. Ethiop Med J 2010, 48(3):195-202.
[19] Kamel MI, Rashed S, Foda N, Mohie A, Loutfy M: Gender differences in health care utilization and outcome of respiratory tuberculosis in Alexandria Eastern Mediterranean Health Journal 2003, 9(4).
[20] Aditi N: Factors affecting patient satisfaction and healthcare quality. International Journal of Health Care Quality Assurance 2009, 22(4):366-381.
[21] Edward NA: Determinants of Consumer Satisfaction of Health Care in Ghana: Does Choice of Health Care Provider Matter? Global journal of health science 2009, 1(2).
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  • APA Style

    Belay Mergya Eticha, Alemayehu Atomsa, Birtukan Tsehaineh, Tezera Moshago Berheto. (2014). Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia. American Journal of Nursing Science, 3(4), 48-55. https://doi.org/10.11648/j.ajns.20140304.12

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    ACS Style

    Belay Mergya Eticha; Alemayehu Atomsa; Birtukan Tsehaineh; Tezera Moshago Berheto. Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia. Am. J. Nurs. Sci. 2014, 3(4), 48-55. doi: 10.11648/j.ajns.20140304.12

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    AMA Style

    Belay Mergya Eticha, Alemayehu Atomsa, Birtukan Tsehaineh, Tezera Moshago Berheto. Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia. Am J Nurs Sci. 2014;3(4):48-55. doi: 10.11648/j.ajns.20140304.12

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  • @article{10.11648/j.ajns.20140304.12,
      author = {Belay Mergya Eticha and Alemayehu Atomsa and Birtukan Tsehaineh and Tezera Moshago Berheto},
      title = {Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia},
      journal = {American Journal of Nursing Science},
      volume = {3},
      number = {4},
      pages = {48-55},
      doi = {10.11648/j.ajns.20140304.12},
      url = {https://doi.org/10.11648/j.ajns.20140304.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajns.20140304.12},
      abstract = {Background: Observing quality from the patient’s perspective is of paramount importance for making the service more responsive to patients. However, little is known about the quality of tuberculosis treatment service from the patient’s perspective in Ethiopia. This study was carried out to assess the quality of tuberculosis treatment services from the patient’s perspective in South Ethiopia’s public health facilities. Methods: A facility-based, cross-sectional study design was employed, and data were collected from February to March, 2012. A QUOTE-TB tool validated for East African countries was used to collect data from a sample of 370 tuberculosis patients receiving treatments at public health facilities. The study participants were allocated proportionally to the number of client receives the service, and the relative importance of the aspects and perception of the quality of their received care was scored. Combining the relative importance and actual performance scores derived a measure of service quality. Analyses were performed using SPSS and statistical significance was set at a p-value less than 0.05. Results: The accommodation aspects of the facilities, patient-provider interactions, health information and communication, and availability of care had low quality impact scores. The highest service quality scores were for TB-HIV integration and cost of treatment. Shorter waiting times (ß=-1.85), routine observation, and checking the daily TB drug intake (ß=-1.26) and treatment by the same health provider (ß=1.13) independently predicted overall patient satisfaction. Conclusion: There were notable differences between TB patients ‘expectations and what they actually received in terms of accommodation, availability, patient-provider interactions, health information, and communication, which were identified as being of inadequate quality. Significant effort is needed to improve the quality of TB care with respect to these particular aspects from the perspectives of patients. Individuals caring for patients with TB in the health service should address these areas of care in order to enhance TB treatment services and satisfy patients.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia
    AU  - Belay Mergya Eticha
    AU  - Alemayehu Atomsa
    AU  - Birtukan Tsehaineh
    AU  - Tezera Moshago Berheto
    Y1  - 2014/07/30
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ajns.20140304.12
    DO  - 10.11648/j.ajns.20140304.12
    T2  - American Journal of Nursing Science
    JF  - American Journal of Nursing Science
    JO  - American Journal of Nursing Science
    SP  - 48
    EP  - 55
    PB  - Science Publishing Group
    SN  - 2328-5753
    UR  - https://doi.org/10.11648/j.ajns.20140304.12
    AB  - Background: Observing quality from the patient’s perspective is of paramount importance for making the service more responsive to patients. However, little is known about the quality of tuberculosis treatment service from the patient’s perspective in Ethiopia. This study was carried out to assess the quality of tuberculosis treatment services from the patient’s perspective in South Ethiopia’s public health facilities. Methods: A facility-based, cross-sectional study design was employed, and data were collected from February to March, 2012. A QUOTE-TB tool validated for East African countries was used to collect data from a sample of 370 tuberculosis patients receiving treatments at public health facilities. The study participants were allocated proportionally to the number of client receives the service, and the relative importance of the aspects and perception of the quality of their received care was scored. Combining the relative importance and actual performance scores derived a measure of service quality. Analyses were performed using SPSS and statistical significance was set at a p-value less than 0.05. Results: The accommodation aspects of the facilities, patient-provider interactions, health information and communication, and availability of care had low quality impact scores. The highest service quality scores were for TB-HIV integration and cost of treatment. Shorter waiting times (ß=-1.85), routine observation, and checking the daily TB drug intake (ß=-1.26) and treatment by the same health provider (ß=1.13) independently predicted overall patient satisfaction. Conclusion: There were notable differences between TB patients ‘expectations and what they actually received in terms of accommodation, availability, patient-provider interactions, health information, and communication, which were identified as being of inadequate quality. Significant effort is needed to improve the quality of TB care with respect to these particular aspects from the perspectives of patients. Individuals caring for patients with TB in the health service should address these areas of care in order to enhance TB treatment services and satisfy patients.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • Disease Prevention and Control Coordinator, Hadiya Zone Health Department, Hosanna, Ethiopia

  • Department of Epidemiology, Jimma University, Jimma, Ethiopia

  • Department of Epidemiology, Jimma University, Jimma, Ethiopia

  • Department of Public Health, Mizan College of Health Sciences, Mizan, Ethiopia

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