Abstract
BackgroundAlthough Ghana does not fall into the category of those countries which have a high burden of tuberculosis (TB), the disease does present considerable economic and health limitations to individuals infected with, and affected by, the disease, as well as to the health system in general. Despite this fact, insufficient studies have been done on the key barriers to controlling the disease. This paper presents results from an exploratory study on the constraints of controlling TB in Ghana based on the opinions of health service providers.MethodsIn-depth interviews were conducted with frontline health workers involved in TB control in the country. Participants were purposively selected from a pool of national and regional, and district and facility level coordinators of the National Tuberculosis Control Programme (NTP). One key informant was also selected from an international non-governmental organisation (NGO) involved in TB-related activities in Ghana. Observations were utilised to complement the study. Data were analysed inductively.ResultsRespondents identified the following as being constraints to TB control: clinical complication, bottlenecks in funding administration, quality of physical infrastructure, competition for attention and funding, unsatisfactory coordination between TB and HIV control programmes, a poor public-private partnership, and weak monitoring and evaluation of interventions.ConclusionsThis paper provides evidence of some key barriers to TB control. The barriers, as reported, were generally health system-based. Although this list of barriers is not exhaustive, it would be useful to take them into account when planning for TB control, thus adopting a more rounded approach to TB management in the country. As well as that, further studies should be done to explore patients’ views on health service-related barriers to TB control.
Highlights
Ghana does not fall into the category of those countries which have a high burden of tuberculosis (TB), the disease does present considerable economic and health limitations to individuals infected with, and affected by, the disease, as well as to the health system in general
Over the years, global disability-adjusted life-years (DALYs) reports have shown that communicable diseases contribute to about 24% of years of life lived with disability (YLD) and 19% of years of life lost (YLL) [1,2]
Other issues covered in the study include the publicprivate partnership, integration of TB and human immunodeficiency virus (HIV), political commitment, as well as barriers to TB control from the perspective of health service providers
Summary
Ghana does not fall into the category of those countries which have a high burden of tuberculosis (TB), the disease does present considerable economic and health limitations to individuals infected with, and affected by, the disease, as well as to the health system in general. Despite this fact, insufficient studies have been done on the key barriers to controlling the disease. Available evidence shows that HIV infection reactivates latent TB infection This accelerates new infections and re-infections, leading to a lifetime risk ranging from 10-20% among individuals having dormant TB. It is one of the most common causes of morbidity and mortality among people living with HIV [5,6]
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