Assessment Of Feasibility Of Implementing Dots In Private Health Facilities In Addis Ababa Ethiopia

Introduction: The MDG of reducing deaths from TB can be achieved, if TB control effortsrnapproach as closely as possible the global goals for case detection of smear positive PTB (70%)rnand cure rate of 85% or above. Currently Ethiopia’s case detection rate stands 36% since the yearrn2002, and unless the current efforts are intensified with innovative approaches, such as therninvolvement of private health care providers in the service delivery, the government with itsrnlimited resources can't reach the target set by MDG regarding TB control. Before directlyrnembarking to the new approach, a baseline assessment of private health facilities capacity andrnwillingness to collaborate in TB control programme is of paramount importance.rnObjective: to assess feasibility of implementing DOTS in private health facilities in AddisrnAbaba. More specifically to assess willingness of private health facility managers, to assesrnstaffs' knowledge, current practices in diagnosis, treatment and referral of Tuberculosis, and tornassess private health facilities’ institutional capacity to provide comprehensive tuberculosisrnprevention and control services.rnMethodology: An institution based, cross sectional descriptive study was carried out fromrnNovember 2005 to June 2006. Feasibility of implementing DOTS was assessed using arnstructured and pre tested interviewer administered questionnaire and observation checklist torncollect the necessary information. A total of 96 health facilities, 96 respondents in charge of thernhealth facilities and 162 health workers were participated in the study. Data were analyzed usingrnSPSS version 10.1 statistical package. Frequency distribution and percentages were used tornpresent findings. Stepwise aggregation of composite variables and their scores to reach torndecision for feasibility were used. Feasibility status was rated as poor, fair, good, very good andrnexcellent based on the attained composite score for the indicator variables.rnResult: The composite score calculated for willingness to implement DOTS is fair (52.1),rngeneral TB knowledge is very good (73.1). Structural capacity, availability of basic laboratoryrnmaterials, general TB related practice and manpower as DOTS center were good with 67.3, 63.9,rn61.0, and 60.7 scores respectively, resulting the over all feasibility status good (63.0).rnxirnConclusion: Implementation of DOTS in private health facilities is feasible, given appropriaternDOTS training, technical assistance and supervision. Piloting of the project in limited areas andrnappropriate facilities is recommended.

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