Health System and Patient Factors Facilitating the Implementation of Isoniazid Preventive Therapy for People living with HIV attending Care and Treatment Centres in Songea Municipality, Tanzania

Abstract

Isoniazid Preventive Therapy (IPT) is an essential public health intervention for people living with HIV (PLHIV), especially in low-income countries with high tuberculosis (TB) and HIV burden. Despite available evidence that IPT is efficacious, its implementation is still low in many countries. Therefore, this study aimed to determine the coverage of IPT implementation and explore factors facilitating the  implementation of IPT in Songea municipality, Tanzania. The study employed a cross-sectional descriptive study design using both quantitative and qualitative approaches of data collection. A review of 2148 records of PLHIV eligible for IPT was done to determine
coverage of IPT implementation. 21 in-depth interviews and 5 observations were conducted to explore factors facilitating IPT  implementation. Overall, IPT coverage of the municipality was estimated to be 45%. The study revealed that the availability of IPT training, regular supportive supervision, collaboration between TB and HIV programs, availability of IPT guidelines and patient registers were the main factors facilitating the implementation of IPT. The study recommends that local government authorities, managements of healthcare facilities, drug suppliers, and partners working in TB and HIV programs, service providers, community leaders and community health workers should continue working together and ensure that the identified facilitating factors are sustained to increase the coverage of IPT to reach at least the minimum 50% as recommended by the WHO.