Patients’ Perspectives of the Quality of Tuberculosis Treatment Services in South Ethiopia

Abstract

Background: Observing quality from the patient’s perspective is of paramount importance for making the service more responsive to patients. However, little is known about the quality of tuberculosis treatment service from the patient’s perspective in Ethiopia. This study was carried out to assess the quality of tuberculosis treatment services from the patient’s perspective in South Ethiopia’s public health facilities. Methods: A facility-based, cross-sectional study design was employed, and data were collected from February to March, 2012. A QUOTE-TB tool validated for East African countries was used to collect data from a sample of 370 tuberculosis patients receiving treatments at public health facilities. The study participants were allocated proportionally to the number of client receives the service, and the relative importance of the aspects and perception of the quality of their received care was scored. Combining the relative importance and actual performance scores derived a measure of service quality. Analyses were performed using SPSS and statistical significance was set at a p-value less than 0.05. Results: The accommodation aspects of the facilities, patient-provider interactions, health information and communication, and availability of care had low quality impact scores. The highest service quality scores were for TB-HIV integration and cost of treatment. Shorter waiting times (ß=-1.85), routine observation, and checking the daily TB drug intake (ß=-1.26) and treatment by the same health provider (ß=1.13) independently predicted overall patient satisfaction. Conclusion: There were notable differences between TB patients ‘expectations and what they actually received in terms of accommodation, availability, patient-provider interactions, health information, and communication, which were identified as being of inadequate quality. Significant effort is needed to improve the quality of TB care with respect to these particular aspects from the perspectives of patients. Individuals caring for patients with TB in the health service should address these areas of care in order to enhance TB treatment services and satisfy patients.