Assessment of the participation of primary care services in national tuberculosis control program in Gharbia Governorate

Abstract

The aim of this work was to evaluate the Primary Health Care service performance in National Tuberculosis Control Program in Gharbia Governorate. Methods: The studied area (Gharbia Governorate) includes 8 health territories (each contains 5 primary care units/centers). A questionnaire based on 6 parameters was used to evaluate the PHC system performance: I – Physicians basic knowledge about TB (causative agent, methods of spread, clinical picture, essential steps in investigations: X-ray and sputum smear), II – Facilities for primary investigation (sputum examination and chest X-ray), III – Communication with the central health authorities or a TB specialist, IV – Proper recording systems needed for proper patient management and follow up, V – Follow up schedules available for the detected patients, VI – a role in community education about the disease. The data obtained were tabulated and statistically analyzed. Results: Studied area included 8 health territories and 40 primary care units (35% were urban and 65% rural) with one physician in each unit. The mean percent of the correct answers of the basic knowledge score was 49.6% (range = 18%–91%), it was higher in urban units physicians than rural units physicians, with lack of proper laboratory (for sputum analysis) or X-ray apparatus. Communication with central health authorities in urban areas was higher than rural areas (71.4% versus 61.5%). Case recording was lower in urban than rural areas (28.6% versus 73.1%). Patient follow up after referral to central health units was higher in rural than urban areas (11.5% versus 7.1%). Participation of community education was 78.6% in urban units and 69.2% in rural units. Conclusion: In Gharbia Governorate, PHC physicians lack proper knowledge about TB and their units lack proper equipments (Lab and CXR). The PHC system needs to be empowered by the health care authorities through training and equipments for better performance in NTP.