Tuberculosis infection control policy and its implementation in high burden dots facilities in Ibadan: A qualitative exploration

Abstract

Background: Following the growing public health problem of Tuberculosis (TB), the TB Infection Control Policy and Guidelines was published in 2009 to reduce the transmission of this disease to healthcare workers and patients. This study assessed the TB policy and the factors influencing its implementation in Ibadan, Oyo  State Nigeria.

Methods: This study was conducted in five of the urban Local Government Areas in Ibadan, Oyo State where  10 Directly Observed  Treatment Services (DOTS) centres with high TB burdens were selected. Eighteen key  informant interviews were conducted with  purposively sampled DOTS Officers, Tuberculosis and Leprosy  Control Program Local Government Supervisors (TBLS) and members of  the State TB Control Program.

Result: Only few of the facilities assessed had a written facility-specific infection control plan (that includes  TB  infection control) and a fifth of the facilities had designated persons (and committees in larger facilities)  responsible for  implementing TBIC policy. There was a general shortfall in the implementation of  administrative control measures except for compliance  to triaging rules as revealed by very poor compliance to  most details of this aspect of the TBIC policy in most of the centres  visited. Poor funding, inadequate support  from the government at all levels, shortage of personnel, inadequate supply of Personal  Protective Equipment  were all identified as the major challenges faced in implementing the TBIC policy.

Conclusion: Awareness on the  content as well as the level of implementation of the policy still fall short of the  WHO recommendation. Policy makers and implementers  need to strengthen the administrative control  measures which has shown to be very effective and efficient in curbing the spread of the  disease.