Accessibility and TB patient satisfaction in Nigeria

Area of Science:

• Public Health
• Health Services Research
• Infectious Disease Epidemiology

Background:

• Nigeria faces a high global burden of tuberculosis (TB), ranking first in Africa and sixth worldwide.
• Poor treatment adherence among drug-susceptible TB (DS-TB) patients contributes to increasing drug resistance.
• A review of TB services is crucial, focusing on accessibility and patient experiences in newly established facilities.

Purpose of the Study:

• To compare the accessibility and patient-reported experiences in newly established public versus private TB treatment facilities in Nigeria.
• To identify factors influencing patient experiences with TB services.
• To inform policy recommendations for improving TB service delivery.

Main Methods:

• A comparative cross-sectional analytic study was conducted in Osun, Nigeria.
• The Patient Reported Experience Measure (PREM) questionnaire was administered to 430 patients with DS-TB.
• Data were collected from 27 public and 18 private facilities and analyzed using R Software.

Main Results:

• Private facilities demonstrated significantly higher accessibility (97.2% vs 90.7%) and patient-reported satisfaction (96.8% vs 90.7%) compared to public facilities.
• A higher proportion of patients in public facilities reported inability to afford transportation costs (52.6% vs 35.8%).
• After adjusting for covariates, private facilities offered 3.12 times higher odds of satisfactory services; facility type, time-to-facility, and marital status were significant predictors of patient experience.

Conclusions:

• Private facilities are more accessible and provide more satisfactory TB services than public facilities in this Nigerian setting.
• The National TB Programme should consider decentralizing TB services to integrate private facilities more effectively.
• Addressing identified gaps in public TB facilities is essential to improve overall service delivery and patient outcomes.