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Performance of the National Tuberculosis Control Program in the post conflict Liberia.

ABSTRACT: BACKGROUND:Tuberculosis is a major public health problem in Liberia. According to the World Health Organization (WHO), the incidence of tuberculosis in Liberia is significantly increasing from year to year. However, little is known about the performance of the programme and the challenges after the 14 years of civil war which ended in 2003.The purpose of the study was to evaluate the performance of the TB programme of Liberia. METHODS:The study utilised mixed research design; both quantitative and qualitative methods were used in this study conducted from 2013 to 2014. For the quantitative part of the study, a questionnaire, laboratory performance and eleven years TB programme data (2003-2013) were used. For the performance of tuberculosis laboratory testing, all the 107 functional tuberculosis microscopy centers in Liberia were included. For the qualitative part of the study, an interview of 10 informants and two focus group discussions (FGDs) were also conducted, each comprising of eight people. Themes and subthemes emerged from the two FGDs. Data was analysed in line with the Donabedian model. Quantitative findings were analysed and presented using both descriptive and inferential statistics. RESULTS:The study findings pointed out that there was overall improvement in the performance of the tuberculosis control programme in Liberia from 2003 to 2013. The percentage of cured patients was 60% in 2005 and 62% in 2013. Percentage of treatment completed was 16% in 2005 and 21% in 2013. The case detection rate was 57% and treatment success rate 80% in 2013. The default rate was 11% in 2013. Of the 139 participants, 120 (86%) completed TB treatment while 19 (14%) did not. CONCLUSION:Between 2003 and 2013, the National Leprosy and Tuberculosis Control Programme (NLTCP) succeeded in restoring the TB services and improving some of the TB treatment outcomes including the Directly observed treatment short courses(DOTS) coverage. Despite these improvements, the TB treatment, laboratory services and human resource capacity lagged behind. The TB programme of Liberia needs to develop new strategies to address its challenges.

SUBMITTER: Desta KT

PROVIDER: S-EPMC6016901 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Performance of the National Tuberculosis Control Program in the post conflict Liberia.

Desta Kassaye Tekie KT Masango T E TE Nkosi Zerish Zethu ZZ

PloS one 20180625 6

<h4>Background</h4>Tuberculosis is a major public health problem in Liberia. According to the World Health Organization (WHO), the incidence of tuberculosis in Liberia is significantly increasing from year to year. However, little is known about the performance of the programme and the challenges after the 14 years of civil war which ended in 2003.The purpose of the study was to evaluate the performance of the TB programme of Liberia.<h4>Methods</h4>The study utilised mixed research design; both ...[more]

PMID: 29940012

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Project description:The National Comprehensive Cancer Control Program (NCCCP) performance measurement system seeks to understand both the processes that funded programs undertake with their respective coalitions to implement the objectives of their cancer plans and the outcomes of those efforts.To identify areas of achievement and technical assistance needs of NCCCP awardees.Program performance was assessed through surveys completed by program directors on performance indicators in 2009 and 2010 and queries from a Web-based management information system in 2011 and 2012.Programs funded by the Centers for Disease Control and Prevention's NCCCP.Sixty-nine programs.The key performance measures assessed were inclusion of diverse partners and key sectors in cancer coalitions, partners' involvement in activities, receiving in-kind resources from partners, using evidence-based interventions and data for setting priorities, conducting program evaluation, using community- or organization-level strategies to address cancer control efforts, and demonstrating progress toward achieving health outcomes.Most programs reported having active coalitions that represent diverse organizational sectors. Nearly all programs routinely assess the burden of cancer. In-kind resources to implement activities peaked at $64 716 in the second year of a 5-year funding cycle and declined in subsequent project years. By year 3, more than 70% of programs reported having an evaluation plan. While programs reported that nearly two-thirds of their interventions were evidence-based, some programs implemented non-evidence-based interventions. A majority of programs successfully used at least 1 community- or organization-level change strategy. However, many programs did not incorporate objectives linked to health outcomes as they reported progress in implementing interventions.While NCCCP programs were strong at building and maintaining infrastructure, some programs may need additional technical assistance to increase the adoption of evidence-based interventions, develop solid and responsive evaluation plans, and better link efforts to population-based measures that demonstrate impact toward reducing the burden of cancer.

Project description:Teaching methods need continuous innovation to encourage undergraduate medical students to enhance their competency level and skills. Every undergraduate medical student should be able to discuss the Revised National Tuberculosis Control Program (RNTCP) and Direct Observed Treatment Short (DOTS) course recommended by the World Health Organization (WHO). The DOTS strategy was launched in 1992, with the objective of detecting at least 70% of new sputum-positive tuberculosis (TB) patients and curing at least 85% of such patients. The aim of this study was to improve the competency level of Undergraduate (UG) Bachelor of Medicine and Bachelor of Surgery (MBBS) students by teaching them the objectives of the RNTCP at a program implementation site in the medical college. The RNTCP could be considered and conducted as Program-Based Teaching and Learning (PBTL) for the UG medical students. The following skills were to be implemented in the RNTCP PBTL: Sputum Collection, Ziehl-Neelsen staining and Grading, Mantoux test, and TB Culture and Molecular test (Gene Xpert). Phase II undergraduate MBBS students (N = 104) participated in the PBTL. This study was conducted in the RNTCP laboratory of a tertiary-care teaching medical college hospital. This descriptive study included advanced skill-based teaching such as Directly Observed Practical Skill, Demonstration-Observation-Assistance-Performance, Video Demonstrations, Role Play, and Group interaction as teaching tools. Pre-/post-test, Objective Structured Practical Examination, and frequently asked questions were used as assessment tools. The pre- and post-test marks were compared, and other assessments were also analyzed using SPSS. At the end of the teaching program, the feedback forms were collected from students and analyzed. The mean score obtained for 104 MBBS students in the pre-test, post-test, and other assessment tools were 213.3 and 487.5, respectively (p < 0.001). We conclude that skill-based teaching and learning tools to teach public health program like RNTCP provide valuable essential skills for undergraduate medical students. This Program Based Teaching and Learning could be successfully extended to all medical colleges.

Dataset Information

Performance of the National Tuberculosis Control Program in the post conflict Liberia.

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Performance of the National Tuberculosis Control Program in the post conflict Liberia.

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