The Perspectives of Patients and Health Professionals Regarding the Tuberculosis Control Programme in Recife, Brazil: A Contribution to Evaluation

Abstract

The study objective is to describe patients and professionals’ perspectives on the Tuberculosis Control Program (PCT) in Recife, Brazil, contributing to the program evaluation. A cross-sectional study was conducted in three purposively selected sites, representing the three levels of care in the public health system. All eligible PCT patients in sites A, B and C were invited to participate (n = 123). Physicians, nurses, pharmacists and community health agents providing care to PCT patients in these sites, plus their managers, were purposively selected. Data were collected by means of interviews with 44 patients and a questionnaire to 24 professionals. Instruments encompassed previously published items to capture stakeholders’ perspectives (16 and 12 closed-questions, respectively), grouped into categories. The overall evaluation by patients was unsatisfactory (median score 35%; third quartile below 50%; interquartile range 21.9%). Analysis of scores by categories showed that opinions about organizational accessibility were significantly worse than about economic and geographical accessibility, taken together. Overall the median score attributed by professionals was 52% (third quartile below 65%). Professionals had significantly worse opinions about diagnosis, clinical and laboratory assistance. Patients and professionals’ perspectives highlight potential opportunities for improvement. Our findings can be used by managers as a starting point for shared decision-making, potentially contributing to a better performance of the PCT in Recife and, consequently, reducing the risk posed by tuberculosis.

Conhecimento Dos Farmacêuticos Da Atenção Primária À Saúde De Belo Horizonte, Minas Gerais, Brasil Sobre Tuberculose

“…O diagnóstico e o tratamento da tuberculose são importantes para a quebra da cadeia de transmissão, diminuição da incidência e redução do número de mortes por TB no Brasil (6). Outros estudos que avaliaram o conhecimento de outros profi ssionais de saúde sobre TB também encontraram bom conhecimento sobre o tratamento (25), mas defi ciências no diagnóstico (26)(27)(28). Percepções equivocadas podem favorecer falhas na orientação terapêutica e diagnóstica, também na geração de falsas crenças, mitos e medos (26,29).…”

Evaluation of the Tuberculosis Control Program in a state of the Brazilian Amazon Region

“…Neste estudo, identificou-se uma heterogeneidade entre os municípios de Rondônia quanto à qualidade da atenção à TB. Tal desempenho também foi observado em outros estados e estiveram relacionados às fragilidades estruturais e deficiências de processo [18][19][20] , implementação parcial da estratégia Directly Observed Treatment Short-Course (DOTS) pelos programas 21 e ineficácia nas ações de prevenção e cuidado da TB, refletindo em desfechos desfavoráveis do tratamento [22][23][24] .…”