Consensual improvement actions for the Tuberculosis Control Programme in Pernambuco state, Brazil: an e-Delphi study

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Tuberculosis (TB) poses a significant global health challenge, disproportionately affecting low and middle-income countries.
• Effective tuberculosis control programs are crucial for disease management and public health.
• The Pernambuco state Tuberculosis Control Programme (SPTC) in Brazil requires strategic improvements.

Purpose of the Study:

• To achieve consensus on actionable improvements for the Pernambuco state Tuberculosis Control Programme (SPTC).
• To identify key structure and process indicators for TB control.
• To generate a prioritized list of feasible and relevant interventions.

Main Methods:

• A preliminary workshop with 8 experts identified TB control indicators.
• An e-Delphi survey involving 11 local TB experts was conducted in three rounds.
• Experts evaluated proposed improvement actions for relevance and feasibility using a four-point scale.

Main Results:

• Eighty-nine improvement actions reached a high consensus on relevance and feasibility.
• Eighty-six actions were categorized under 19 structure and process indicators.
• Ten actions, including "Request and availability of sputum pots can be made by any health professional in the health unit," received the highest ratings.

Conclusions:

• The Delphi process yielded a comprehensive set of improvement actions for TB control.
• Local SPTC services can utilize these actions to tailor interventions to specific contexts.
• The ten most relevant and feasible actions provide a strategic foundation for improving TB program outcomes.