Obstacles of ending TB: What does health system think?
Social Determinants of Health,
Vol. 4 No. 1 (2018),
10 June 2018
,
Page 18-28
https://doi.org/10.22037/sdh.v4i1.20927
Abstract
Background: Despite the importance of Tuberculosis (TB) control program and elimination of disease as its target, only a few studies have been carried out to evaluate tuberculosis control in Iran. In the present study, we intended to ask the opinions from experts and managers of Iran University of Medical Sciences about the TB control program in Iran.
Methods: A Qualitative study was carried out to determine experts’ and managers’ opinions about the national TB control program. Experts and stakeholders were listed for focus group discussions (FGD) and interviews using purposive sampling method. We interviewed all levels of staff involved in the tuberculosis control program (managers, physicians, and administrative and executive staffs). Three FGD sessions were held with 28 participants. The participants were excluded if they had less than six months of experience in TB program. FGD and interviews were manually coded and the themes and sub-themes were extracted. After analyzing the results, the final report was drafted.
Results: The results were classified into four themes and 15 subthemes (6 in input, 3 in process, 2 in outputs, and 4 in outcome). There were positive points and problems in each part. To achieve the goal of End TB, we will need to review the process, incorporate with other sectors, apply new diagnostic methods, and participate with other stakeholders (internal and external).
Conclusion: Because of the effects of socio-economic factors on tuberculosis, considering the current implementation of the program; it is not possible to eliminate tuberculosis.
- Iran
- Qualitative Research
- Tuberculosis
How to Cite
References
World Health Organization. Global Tuberculosis Report 2017. Geneva: World Health Organization.
Khaiatzadeh S, Seif M, Talebi M. Assessment of epidemiologic indicators of national TB program in Azarbaijan 1998 -2004. Kerman University of Medical Sciences Journal. 2006;13(2):75.
Moosazadeh M, Nasehi M, Bahrampour A, Khanjani N, Sharafi S, Ahmadi S. Forecasting tuberculosis incidence in iran using box-jenkins models. Iran Red Crescent Med J. 2014;16(5):e11779.
Farzianpour F, Kooshad MA. Study of the Status of Tuberculosis Control Program Based on the Implementation of the Directly Observed Treatment Short-course Strategy (DOTS). Mater Sociomed. 2016; 28(4):249-252.
Falzon D, Migliori GB, Jaramillo E, Weyer K, Joos G, Raviglione M; Global Task Force on digital health for TB. Digital health to end tuberculosis in the Sustainable Development Goals era: achievements, evidence and future perspectives. Eur Respir J. 2017;50(5).
World Health Organization. The End TB Strategy. Geneva, Switzerland: World Health Organization; 2015. WHO/HTM/TB/2015.19. Available from: http://www. who. int/tb/End_TB_brochure. pdf; 2017.
World Health Organization. Tuberculosis (TB). Available from: http://www.who.int/tb/en/. Accessed March 4, 2018
Manzouri L, Faraghzadegan Z, Babak A, Farid F, Fadaeinobari R. Tuberculosis Program Evaluation in Isfahan District. Journal of Isfahan Medical School. 2010;27(102):742-752.
Moosazadeh M, Khanjani N. The Existing Problems in the Tuberculosis Control Program of Iran: A Qualitative Study. Journal of Qualitative Research in Health Sciences 2012;1(3):189-201.
Reform in Health care System. Available from: https://mui.ac.ir/sites/default/files/library/%D8%A8%D8%B1%D9%86%D8%A7%D9%85%D9%87%20%D8%AA%D8%AD%D9%88%D9%84%20%D9%86%D8%B8%D8%A7%D9%85%20%D8%B3%D9%84%D8%A7%D9%85%D8%AA%20%D8%AF%D8%B1%20%D8%AD%D9%88%D8%B2%D9%87%20%D8%A8%D9%87%D8%AF%D8%A7%D8%B4%D8%AA.pdf. Accessed April 21, 2018.
Cass A, Shaw T, Ehman M, Young J, Flood J, Royce S. Improved Outcomes Found After Implementing a Systematic Evaluation and Program Improvement Process for Tuberculosis. Public Health Rep. 2013;128(5):367-376.
Arakawa T, Magnabosco GT, Lopes LM, Arnaez MA, Gavín MA, Gallardo Mdel P, et al. Evaluation of the performance of Tuberculosis Control Programs in Brazil and Spain: an integrative review of the literature. Cien Saude Colet. 2015;20(12):3877-89.
Volmink J, Garner P. Systematic review of randomised controlled trials of strategies to promote adherence to tuberculosis treatment. BMJ: British Medical Journal. 1997;315(7120):1403..
Munje R, Deshmukh R, Tumane K. Multidrug-resistant TB among previously treated TB cases: A retrospective study in Nagpur, India. Indian J Tuberc. 2015;62(4):207-10.
Conseil A, Mounier-Jack S, Rudge JW, Coker R. Assessing the effects of HIV/AIDS and TB disease control programmes on health systems in low- and middle-income countries of Southeast Asia: a semi-systematic review of the literature. Public Health. 2013;127(12):1063-73.
Shadpour K. Health sector reform in Islamic Republic of Iran. Hakim Research Journal. 2006;9(3):1-8.
Rashidian A. Policy Making Challenges, and the Need for Introducing Formal Structures for Evidence Informed Decision Making in the Health System. Hakim Research Journal 2014;16(3): 258-261. (Full text in Persian)
Long R, Heffernan C, Gao Z, Egedahl ML, Talbot J. Do “Virtual” and “Outpatient” Public Health Tuberculosis Clinics Perform Equally Well? A Program-Wide Evaluation in Alberta, Canada. PLoS One. 2015;10(12): e0144784.
Fatima R, Qadeer E, Enarson DA, Creswell J, Stevens RH, Hinderaker SG, Anwar K, ul Haq M. Success of active tuberculosis case detection among high-risk groups in urban slums in Pakistan. Int J Tuberc Lung Dis. 2014;18(9):1099-104.
Thind D, Charalambous S, Tongman A, Churchyard G, Grant AD. An evaluation of 'Ribolola': a household tuberculosis contact tracing programme in North West Province, South Africa. Int J Tuberc Lung Dis. 2012;16(12):1643-8.
Podewils LJ, Bantubani N, Bristow C, Bronner LE, Peters A, Pym A, Mametja LD. Completeness and Reliability of the Republic of South Africa National Tuberculosis (TB) Surveillance System. BMC Public Health. 2015;15:765.
Dokubo EK, Odume B, Lipke V, Muianga C, Onu E, Olutola A, et al. Building and Strengthening Infection Control Strategies to Prevent Tuberculosis - Nigeria, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(10):263-6.
Colvin C, Mugyabuso J, Munuo G, Lyimo J, Oren E, Mkomwa Z, Makame M, Mwangomale A, Mahamba V, Mueller L, Richardson DA. Evaluation of community-based interventions to improve TB case detection in a rural district of Tanzania. Glob Health Sci Pract. 2014;2(2):219–225.
Liu Q, Liu L, Vu H, Liu X, Tang S, Wang H. Comparison between peer-led and teacher-led education in tuberculosis prevention in rural middle schools in Chongqing, China. Asia Pac J Public Health. 2015;27(2):NP2101-11.
Khortwong P, Kaewkungwal J. Thai health education program for improving TB migrant's compliance. J Med Assoc Thai. 2013;96(3):365-73.
Gopu GS, Rao VB, Vadivet J. Impact of health education on the knowledge of tuberculosis among sputum-positive pulmonary TB patients and their care-givers. Nurs J India. 2012;103(4):160-2.
Kundu D, Chopra K, Khanna A, Babbar N, Padmini TJ. Accelerating TB notification from the private health sector in Delhi, India. Indian J Tuberc. 2016;63(1):8-12.
Hu H, Chen J, Sato KD, Zhou Y, Jiang H, Wu P, Wang H. Factors that associated with TB patient admission rate and TB inpatient service cost: a cross-sectional study in China. Infect Dis Poverty. 2016;5:4.
- Abstract Viewed: 419 times
- PDF Downloaded: 171 times