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Improving access and quality of care in a TB control programme
Vera Scott1, Virginia Azevedo, Judy Caldwell
1School of Public Health, University of the Western Cape, Bellville, Western Cape, South Africa. verascott@mweb.co.za
Summary
A quality improvement initiative in Cape Town enhanced tuberculosis (TB) diagnosis and care, particularly for high-risk individuals. The program successfully improved case finding and treatment adherence, leading to better TB outcomes.
Area of Science:
- Public Health
- Infectious Disease Management
- Quality Improvement Science
Background:
- Tuberculosis (TB) diagnosis and care access faced challenges in Cape Town.
- Quality improvement initiatives are crucial for strengthening healthcare services.
Purpose of the Study:
- To implement a quality improvement approach to enhance TB diagnosis and care access in Cape Town.
- To identify and address weaknesses in TB diagnostic and care pathways.
Main Methods:
- Conducted five HIV/AIDS/sexually transmitted infections/TB (HAST) evaluations between 2008 and 2010.
- Utilized facility manager interviews and client record reviews for data collection.
- Employed sub-district workshops and district-wide meetings for quality improvement planning and strategy sharing.
Main Results:
- Improved access for high-risk clients through routine TB case finding in HIV and antiretroviral treatment (ART) services.
- Increased routine measurement of body mass index (20% to 62%) and contraception assessment (27% to 58%).
- Enhanced care for co-infected clients, including better use of HIV stationery and ART eligibility assessment.
Conclusions:
- The HAST audit improved TB cure rates by supplementing routine data and engaging local stakeholders.
- The quality improvement process successfully identified and addressed local opportunities for TB program strengthening.
- Collaborative efforts involving sub-district and facility managers were key to program enhancement.
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