Abstract
Objectives: Tuberculosis (TB) remains a major public health problem, particularly in low and middle-income countries. The aim of this study is to consensualise improvement actions for the Tuberculosis Control Programme of the Pernambuco state (SPTC), Brazil. Methods: Firstly, a preliminary workshop was conducted with experts (n = 8), including key stakeholders and health professionals, to select structure and process indicators pertaining to the tuberculosis control programme. Then, an e-Delphi was carried out with a purposive sample of 11 local TB experts. The first-round questionnaire was comprised of 19 open-ended questions on possible improvement actions, based on programme indicators obtained in the previous stage. In the second-round experts rated each action for relevance and feasibility, using a four-point scale. In the last round the participants rated the actions again, in the light of group's answers. We used published criteria to define consensus at the outset of the study. Key findings: Eighty-nine improvement actions achieved a high degree of consensus in both feasibility and relevance in round three. Eighty-six actions were grouped under 19 structure and process indicators, while three were consideredcross-sectional in scope (i.e. related to more than one indicator). Ten out of the 86 actions obtained at least 70% of ratings on the highest score of the scale both for relevance and feasibility. These included: “Request and availability of sputum pots can be made by any health professional in the health unit”. Conclusions: The wide array of actions obtained in this Delphi represent a resource from which local SPTC services can select the actions most suitable for each context. The ten most relevant and feasible actions represent a particularly useful starting point to streamline change and potentially improve programme indicators.
Highlights
Tuberculosis (TB) remains a major health problem, deserving considerable attention, in low and middle-income countries [1,2].In Brazil, disease control actions are part of the National Tuberculosis Control Programme (NTCP), which is developed in the public network of the health system (Sistema Único de Saúde -SUS)
Firstly, a preliminary workshop was conducted with experts (n = 8), including key stakeholders and health professionals, to select structure and process indicators pertaining to the tuberculosis control programme
The first-round questionnaire was comprised of 19 open-ended questions on possible improvement actions, based on programme indicators obtained in the previous stage
Summary
In Brazil, disease control actions are part of the National Tuberculosis Control Programme (NTCP), which is developed in the public network of the health system (Sistema Único de Saúde -SUS). This programme provides universal access to TB prevention, surveillance and management. FHS provides primary care for defined populations throughmultidisciplinary healthcare teams, comprised by a physician, a nurse, a nurse assistant and four to six full-time paid community health workers, who are lay members. NTCP actions can be implemented in different sites: in people’s homes, by FSH members (e.g. giving information about the disease), in Basic Health Units (e.g. referring patients for laboratory tests), or in outpatient units by referral from primary care (e.g. treatment)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
