Evaluation of quality of TB control services by private health care providers in Plateau state, Nigeria; 2012

Introduction: Tuberculosis (TB) is public health concern in Nigeria. The country uses the Directly  Observed Treatment Short course (DOTS) strategy for its control. Plateau state started using the DOTS strategy in 2001 and had the Private health facilities (PHF) as an important stakeholder. We evaluated their contributions to case finding and quality of the services to identify gaps in monitoring and evaluation in the TB control services within the PHF to plan for intervention so as to meet the set target for TB control in the state. Methods: We used the logical framework approach to identify and analyze the  problem. We drew up an objective tree and from the objective tree developed a logical framework matrix including evaluation plan. We also conducted desk review to extract data on case findings, case  management and outcomes of the treatment. We interviewed TB focal persons and laboratory personnel using structured questionnaire. The data was analyzed using excel spread sheet. Results: Of the 127 health facilities with TB patients on treatment 27 (21.3%) were PHF. The PHF reported 54.6% (1494) of TB cases in 2011. The sputum conversion rates, cured rate, treatment success rate, and default rates were 85%, 73%, 81.4% and 6.6% respectively. The discordant rates were 3.1% and 1.2% for the state and private health facilities respectively. Conclusion: Log frame approach is a useful tool for evaluation of TB control services and helps provide evidence for decision making to improve quality of the TB services in the public and private health facilities in the state.Key words: Private facilities, Tuberculosis, monitoring and evaluation, Logframe approac

Factors associated with interruption of treatment among Pulmonary Tuberculosis patients in Plateau State, Nigeria. 2011

Introduction: Nigeria has one of the highest tuberculosis (TB) burdens in the world with estimated  incidence of 133 per 100,000 populations. Multi-drug resistant TB (MDR-TB) is an emerging threat of the  TB control in Nigeria caused mainly by incomplete treatment. This study explored factors that affect  adherence to treatment among patients undergoing direct observation of TB treatment in Plateau state,  Nigeria.Methods: Between June and July 2011, we reviewed medical records and interviewed randomly selected pulmonary TB patients in their eighth month of treatment. Information on patients? clinical, socio- demographic and behavioral characteristics was collected using checklist and structured questionnaire for knowledge of treatment duration and reasons for interruption of treatment. We conducted focus group discussions with patients about barriers to treatment adherence. Data were analyzed with Epi Info  software. Results: Of 378 records reviewed, 229 (61%) patients were male; mean age 37.6 ±13.5 years and 71 (19%) interrupted their treatment. Interruption of treatment was associated with living > 5 km from TB treatment site (AOR: 11.3; CI 95%: 5.7-22.2), lack of knowledge of duration of treatment (AOR: 6.1; CI 95%: 2.8-13.2) and cigarette smoking (AOR: 3.4; CI 95%: 1.5- 8.0). Major reasons for the interruption were lack of transport fare (40%) and feeling well (25%). Focused group discussions revealed unfriendly attitudes of health care workers as barriers to adherence to treatment. Conclusion: This study revealed knowledge of the patients on the duration of treatment, distance and health workers  attitude as the major determinants of adherent to TB treatment. Training for health care workers on  patient education was conducted during routine supportive supervision.Key words: Interruption, treatment, Tuberculosis, Nigeri

Effects of Work-Family Conflict on job satisfaction of academicians in private universities in Bangladesh: a Structural Equation Modelling approach

The current study attempts to examine the effects of Work-Family Conflict (W-FC) on job satisfaction of academicians. The researchers gathered the data using convenience sampling technique administered on 211 respondents who were academicians of private universities in Bangladesh. Various statistical measures such as descriptive statistics and zero-order correlation were used to explore the relationships between WFC, FWC and job satisfaction. In addition, the Structural Equation Modeling (SEM) technique was adopted to test the effects of WFC and FWC on job satisfaction. Consequently, in terms of the effects, WFC has significant negative effect on job satisfaction while FWC does not show any significant effect on job satisfaction. This study recommends that higher authorities of universities in Bangladesh should take necessary initiatives to minimize the W-FC of academicians in order to ensure their job satisfaction