Original Research Article
Year: 2019 | Month: July-September | Volume: 4 | Issue: 3 | Pages: 120-126
A Qualitative Study to Assess the Availability of Resources at Microscopic Centers for Tuberculosis (TB) Screening in Kalutara District Sri Lanka
YJ Samarasinghe1, V Kumarapeli2, P Wijenayake3, U Gunethilake4, SJ Rathnayake5, TDRN Perera6
11Registrar MD Medical Administration, Post graduate Institute of Medicine, Sri Lanka
2Director Primary Healthcare and Policy Development unit, Ministry of health Sri Lanka
3Director, Research Unit, Ministry of health Sri Lanka
4Registrar MD Medical Administration, Post graduate Institute of Medicine, Sri Lanka
5Registrar MD Medical Administration, Post graduate Institute of Medicine, Sri Lanka
6Registrar MD Venereology, Post graduate Institute of Medicine, Sri Lanka
Corresponding Author: YJ Samarasinghe
ABSTRACT
Background: Annually, nearly 17,000 of TB cases are estimated in Sri Lanka but only around 11,000 new cases are reported. The Ministry of health (MOH) states that there is significant underutilization of MCs in island wide. Availability of resources at MC such as Public Health laboratory Technicians (PHLTS), guidelines, laboratory equipment is important for the screening process enabling efficient utilization of MC.
Objectives: To assess the availability of resources at Microscopic Centers in Kalutara district.
Methods: A qualitative descriptive cross sectional study was carried out in MC during January 1st to 31st March of 2017. All the staff members(n=10) involved TB screening such as Regional Epidemiologist(RE), District Tuberculosis Control Officer(DTCO), Medical Officer of Planning(MOP), Public Health Laboratory Technicians(PHLT), Tuberculosis Assistants(TBA) were taken to study population. Key informant interviews were held using a semi structured interviewer guide. On analyzing the qualitative data, Grounded theory along with constant comparative methodology was followed.
Results: Of the participants, Mean age is 43.6 years (SD=7.94) and 60%, were females (n=6). All participants (n=10) emphasized that staff is not adequate. Of the participants 70% (n=7) stated that training is not adequate. Majority of staff said that the provision of WHO recommended safety goggles (90%, n=9), N95 or FFP2 equivalent safety masks (100%, n=10) and provision of disinfectants (70%, n=7) were inadequate. None of the MCs had an established cough area while MC at Panadura was very unsafe.
Conclusions & Recommendations: The PHLTs and TBAs are inadequate and their In-service training programs (ISP) were not adequately conducted. Annual ISP for MC staff and long term recruitment plan is recommended. WHO recommended deficient essential resources are recommended to purchase through annual estimates of regional Directorate of Health services (RDHS) or National Program for Tuberculosis and Chest Diseases (NPTCCD). Pandura MC needs to shift to safer place to minimize vulnerability.
Keywords: Microscopic Centers, Resource availability, Underutilization, Tuberculosis