加强方案扩展:应用实施研究的综合框架,评估尼日利亚南部的分散的耐药结核病服务
Ngozi Murphy-Okpala1, Chinwe Eze1, Edmund Ndudi Ossai2,3
1Programs Department, RedAid Nigeria, Enugu, Nigeria.
PloS one
|February 21, 2025
概括
尼日利亚的分散的耐药结核病 (DR-TB) 服务显示了更多的促进者而不是障碍,这表明成功实施和优势比集中护理. 这些发现支持在全国范围内扩大可访问的耐药结核病治疗.
科学领域:
- 公共卫生 公共卫生
- 实施科学 实施科学
- 传染病管理 传染病管理
背景情况:
- 耐药结核病 (DR-TB) 服务在尼日利亚各州分散,治疗前损失至后续损失很高.
- 了解实施方便者和障碍者对于计划扩展至关重要.
研究的目的:
- 确定尼日利亚阿克瓦伊博姆州和奥约州去中心化DR-TB服务实施的推动因素和障碍.
- 为扩大分散的DR-TB服务提供可操作的战略.
主要方法:
- 与40个利益相关者进行半结构化关键信息员访谈.
- 使用NVivo软件进行模板分析,以实施研究综合框架 (CFIR) 为指导.
主要成果:
- 促进者包括干预设计,患者跟踪,志愿者联络官,WhatsApp,私营部门参与和同行辅导员.
- 障碍包括口头尸检的挑战,USSD采用率低,测试定价,电力供应以及农村设施/专业知识不足.
- 内部设置因素,如现有基础设施和劳动力,以及关键事件也影响了实施.
结论:
- 分散的DR-TB服务更容易实施,并比集中式模式提供优势.
- 关键推动因素与创新,个体特征和内部设置动态有关.
- 大多数障碍是可修改的,为尼日利亚和类似的LMIC环境的全国采用提供了信息.
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