Readiness of healthcare facilities with tuberculosis services to manage diabetes mellitus in Tanzania: A nationwide analysis for evidence-informed policy-making in high burden settings

Abstract

Introduction Double disease burden such as Tuberculosis and Diabetes mellitus comorbidity is evident and on rising especially in high burden settings such as Tanzania. There is limited information about the availability of tuberculosis/diabetes integrated healthcare services in Tanzania. Therefore, this study explored the availability and examined the readiness of healthcare facilities with tuberculosis services to manage diabetes mellitus in Tanzania. Methods We abstracted data from the 2014–2015 Tanzania Service Provision Assessment Survey datasets. The service availability was assessed by calculating the proportion of tuberculosis facilities reported to manage diabetes mellitus. There were four domains; each domain with some indicators for calculating the readiness index. High readiness was considered if the tuberculosis facilities scored at least half (≥50%) of the indicators listed in each of the four domains (staff training and guideline, diagnostics, equipment, and medicines) as is recommended by the World Health Organization-Service Availability and Readiness Assessment manual while low readiness for otherwise. Results Out of 341 healthcare facilities with tuberculosis services included in the current study, 238 (70.0%) reported providing management for diabetes mellitus. The majority of the facilities were dispensaries and clinics 48.1%; publicly owned 72.6%; and located in rural 62.6%. Overall, the readiness of tuberculosis facilities to manage diabetes was low (10.8%). Similarly, the readiness was low based on the domain-specific readiness of trained staff and guidelines. Conclusion Although the majority of the healthcare facilities with tuberculosis services had diabetes mellitus services the overall readiness was low. This finding provides a piece of evidence to inform the policymakers in high burden and low resource countries to strengthen the co-management of tuberculosis and diabetes.

The Impact of Blood Glucose Levels on Acid-Fast Bacteria Conversion in Tuberculosis Patients with Diabetes Mellitus

“…26,27 On the other hand, TB in a patient with diabetes is associated with poorer glycemic control. 28,29,30 This synergism between DM and TB in terms of epidemiology and outcome necessitates. Bi-directional screening for the presence of either TB or DM in the presence of the other disorder 31 The higher risk of TB in the diabetic population compels intensive screening for detection of TB at the earliest time to reduce transmission, morbidity, and mortality.…”

Service availability, readiness and health-seeking behavior of gender based violence survivor services in primary healthcare facilities in Dodoma, Tanzania. An Explanatory-sequential study design

“…The score of 50 and above will indicate availability of GBV survivor’s services while the score below 50 will indicate unavailability of GBV survivor’s services. This cut-off point of 50% was also used in previous studies (31,32).…”

“…The score of 50 and above will indicate availability of GBV survivor's services while the score below 50 will indicate unavailability of GBV survivor's services. This cut-off point of 50% was also used in previous studies (31,32). GBV survivor's service readiness is the ability of the facility to respond to GBV survivors in a survivor-centred approach by having the necessary guidelines and utilities to facilitate service provision e.g.…”

“…The score of 50 will indicate readiness while the score below 50 will indicate not ready status of the primary healthcare facility to provide GBV survivor's services. The cut-off point is based on the previous studies (31,32). and the ethical principles to adhere to during the whole time of the study.…”