Structural guidelines for the sustainability of the tuberculosis infection control plan

The district of Santiago de Cali is the second territorial entity with the highest number of tuberculosis cases in Colombia. Since 2016, the Secretaría de Salud Pública has implemented the infection control plan in health service provider institutions with active tuberculosis programs, making its evaluation necessary.

To contrast the regulatory aspects and contextual elements that influence the operation of the infection control plan for tuberculosis, in order to document good practices and areas for improvement in health service provider institutions.

An evaluative study with a mixed-methods approach was conducted to analyze institutional capacities of the infection control plan. The quantitative component included document review and assessment of administrative, environmental, and respiratory control measures. The qualitative component –through a case study–analyzed regulations, governance, financing, information systems, infrastructure, and staff training. Data were integrated through triangulation.

Average compliance of the infection control plan was 70.8% for administrative measures, 62.1% for environmental control, and 90.5% for respiratory health control. The study identified the absence of specific national regulations, high staff turnover, lack of training, gaps in investment and environmental system maintenance, and weak monitoring of occupational tuberculosis. Strengths included the identification of respiratory symptomatic individuals and the availability of respiratory protection equipment.

Structural gaps were identified, associated with the lack of a national regulatory framework, governance weaknesses, financial limitations, and deficiencies in monitoring and training. It is recommended to define responsibilities, allocate resources, and establish operational protocols in health service provider institutions. Ensuring the sustainability of the infection control plan requires monitoring indicators, periodic audits, and continuous training.