Original Research
Patient satisfaction with directly observed treatment and multidrug-resistant tuberculosis injection administration by lay health workers in rural Eswatini
Submitted: 06 October 2019 | Published: 26 May 2020
About the author(s)
Ernest Peresu, Centre for Development Support, Faculty of Economic and Management Sciences, University of the Free State, Bloemfontein, South AfricaChristo J Heunis, Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa
Gladys N Kigozi, Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, South Africa
Diana De Grave, Faculty of Business and Economics, University of Antwerp, Antwerp, Belgium
Abstract
Background: The human resources for health crisis in rural Eswatini led to a novel community-based multidrug-resistant tuberculosis (MDR-TB) treatment strategy based on task-shifting, that is delegation of directly observed treatment (DOT) and administration of MDR-TB injections, traditionally restricted to professional nurses, to lay community treatment supporters (CTSs).
Aim: This study assessed the level of patient satisfaction with receiving community-based MDR-TB care from a CTS.
Setting: The study was conducted at three MDR-TB-treating facilities in the mostly rural Shiselweni region.
Methods: A cross-sectional survey of a purposive sample of 78 patients receiving DOT and intramuscular MDR-TB injections from CTSs was carried out in 2017. Descriptive statistics and regressions were calculated.
Results: A high overall general patient satisfaction score for receiving community-based MDR-TB care from a CTS was observed. Adherence counselling, confidentiality, provider selection and treatment costs significantly (p < 0.05) influenced satisfaction. A large majority (n = 62; 79.5%) of patients indicated that they would likely recommend their significant others to receive MDR-TB care from a CTS. Respondents identified the need to provide CTSs with adequate training, regular supervision and sufficient incentives and also to broaden the scope of their services.
Conclusion: This study observed that task-shifting of DOT and MDR-TB injection administration to CTSs was supported from a patient perspective. However, adherence counselling, confidentiality, provider selection and treatment costs should be taken into account in community-based MDR-TB care programming. Further to the patients, community-based tuberculosis care could be enhanced by improving CTSs’ training, supervision and incentives, and broadening the scope of their services.
Keywords
Metrics
Total abstract views: 3357Total article views: 4448
Crossref Citations
1. Second-line injectable drugs for rifampicin-resistant tuberculosis: better the devil we know?
Sabira Tahseen, Armand Van Deun, Bouke C de Jong, Tom Decroo
Journal of Antimicrobial Chemotherapy vol: 76 issue: 4 first page: 831 year: 2021
doi: 10.1093/jac/dkaa489