BACKGROUND: TB remains one of the leading causes of death in Nigeria, and despite progress in treatment coverage, a 56% gap in national case notifications remains. This gap is attributable in part to underdiagnosis due to missed cases in health facilities. The TB Surge intervention presented an opportunity to address barriers to optimal case detection in public health facilities.
METHODS: KNCV Nigeria implemented the TB Surge intervention under the USAID-funded TB-LON Project in 1,041 public facilities from June 2020 to September 2022. Trained ad-hoc staff screened hospital attendees, linked identified presumptive TB cases to diagnosis and confirmed TB cases to treatment. Data were reported using the Commcare application. Robust project monitoring was used to address gaps.
RESULTS: Of a total of 12,195,874 hospital attendees screened for TB, 729,369 identified as presumptive TB were tested and 65,029 TB cases were diagnosed; 8% of the TB cases were children. Overall TB yield was 9%. Medical ward service delivery point had the highest TB yield of 21%. The number needed to test was 11 and the number needed to screen was 188.
CONCLUSIONS: The TB Surge intervention was of strategic importance in addressing missed cases and barriers to prompt TB diagnosis in health facilities.
BACKGROUND: La TB reste l’une des principales causes de décès au Nigeria et, malgré les progrès réalisés en matière de couverture thérapeutique, il subsiste un écart de 56% dans la déclaration des cas à l’échelon national. Cet écart s’explique en partie par le sous-diagnostic dû aux cas manqués dans les centres de santé. L’intervention TB Surge a permis de lever les obstacles à la détection optimale des cas dans les centres de santé publique.
UNASSIGNED: KNCV Nigeria a mis en œuvre l’intervention TB Surge dans le cadre du projet TB-LON financé par l’USAID dans 1 041 centres publics de juin 2020 à septembre 2022. Le personnel ad hoc formé a dépisté les personnes présentes à l’hôpital, lié les cas de TB présomptifs identifiés au diagnostic et les cas de TB confirmés au traitement. Les données ont été communiquées à l’aide de l’application Commcare. Un suivi rigoureux du projet a permis de combler les lacunes.
UNASSIGNED: Sur un total de 12 195 874 patients hospitalisés ayant fait l’objet d’un dépistage de la TB, 729 369 cas présumés de TB ont été testés et 65 029 cas de TB ont été diagnostiqués ; 8% des cas de TB étaient des enfants. Le rendement global de la TB était de 9%. Le point de prestation de services du service médical a enregistré le taux de TB le plus élevé (21%). Le nombre de tests nécessaires était de 11 et le nombre de dépistages nécessaires de 188.
CONCLUSIONS: L’intervention TB Surge a été d’une importance stratégique pour traiter les cas non détectés et les entraves à un diagnostic rapide de la TB dans les centres de santé.

BACKGROUND: The health sectors success has been determined by consistent and reasonably priced health commodities supply. Despite possible death from the disease, Tuberculosis (TB) can be prevented with early diagnosis and appropriate treatment for which enough, effective, and qualified medicines need to be available. However, studies revealed stock of anti-TB drugs in health facilities. Here we present the recent finding on determinants of stock out of Anti-TB drug at public health facilities of Addis Ababa.
OBJECTIVE: This study aimed to identify determinants of stock outs of first line anti TB drugs at public health facilities under Addis Ababa City Administration Health Bureau.
METHODS: Mixed study design were employed. A total of 106 facilities were included in the sampling frame and data were collected from the study population such as drug store managers of health facilities providing TB treatment using semi structured questionnaire and through in-depth interview with Addis Ababa hubs of the Ethiopian Pharmaceuticals Supply Agency (EPSA), Addis Ababa City Administration Health Bureau and selected heads of pharmacy departments of health facilities from May 1-30, 2020 considering one year back retrospective data from March 20,2019 to March 20,2020. Structured record review of data from Logistics Management Information System (LMIS) tools having TB drugs was done using structured observation checklist. Data were entered, cleaned, and analyzed using SPSS Version 20. Both descriptive and multiple logistic regression analysis were performed.
RESULTS: 52(62.7%) of health facilities encountered stock out for at least one of these drugs during the past 1 year. Rifampicin 75 mg + Isoniazid 50 mg (RH 75/50 mg) were most stocked out first line anti-TB drug from 33(39.8%) of facilities with 17 mean stocks out days while Rifampicin 75 mg + Isoniazid 50 mg + Pyrazinamide 150 mg (RHZ 75/50/150 mg) were the least first line anti-TB drug stocked out from facilities with mean 5 days of stock out. Delayed supply of anti TB drug from EPSA, delivery of reduced quantity of anti TB drugs by EPSA and stocked out of anti TB Drugs at EPSA were significant determinate factors of stock out of first line anti-TB drug from facilities with 95%CI of 10.34(2.167-49.329), 11.452(2.183-60.079) and 5.646(1.240-25.707) respectively.
CONCLUSIONS: Above median of health facilities encountered stock out of first line anti-TB drug in Addis Ababa. Delayed supply of anti TB drug from EPSA, delivery of reduced quantity of anti TB drugs by EPSA and stocked out of anti TB Drugs at EPSA were significant determinate factor of stocked out of first line anti-TB drug from facilities. EPSA and other responsible bodies shall work collaboratively to improve their service and ensure availability of adequate amount of Anti TB drug in health facilities.

Globally, more than 20 million newborns are born with low birth weight (LBW) every year. Most of the LBW occurs in low- and middle-income countries. It is the most critical risk of neonate mortality. Therefore, this study aims to identify determinants of low birth weight among women who gave birth in public health facilities in the North Shewa zone. Institutional-based unmatched case-control study was conducted from February to June 2020 to select 180 cases and 380 controls. Interviewer-administered questionnaire was used to collect data. Data were entered through EPI Info and exported to Statistical Package for Social Science (SPSS) for analysis. Text, percentage and tables were used to present data. Bivariate and multivariate logistic regression analyses were performed to see the association and adjusted odds ratios with 95% confidence interval (CI), and P-value < .05 was considered to declare statistical significance. Lack of nutritional counseling (adjusted odds ratio [AOR] = 2.14; 95% CI = [1.13, 4.04]), unable to take iron-folate supplement (AOR = 2.3.78; 95% CI = [2.1, 6.85]), insufficient additional meal in take (AOR = 6.93; 95% CI = [3.92, 12.26]), restriction of foods (AOR=2.29; 95% CI =[1.81, 4.09]), maternal mid upper arm circumference (MUAC) < 23 cm (AOR=2.85; 95% CI = [ 1.68, 4.85]), maternal height ≤155 cm (AOR=3.58; 95% CI = [1.92, 6.7]), anemia (AOR = 2.34; 95% CI = [1.21, 4.53]), pregnancy-related complications (AOR=3.39; 95% CI = [2.02, 5.68]), and alcohol drinking during pregnancy (AOR = 2.25; 95% CI = [1.24, 4.08]) were significantly associated with LBW. Nutritional counseling, iron-folate supplementation, additional meal intake, restriction of some foods in pregnancy, MUAC of the mother, maternal stature, maternal anemia status, pregnancy-related complications, and a history of alcohol drinking during pregnancy were identified as determinants of low birth weight. The intervention-targeted nutritional counseling, early detection and treatment of anemia, and behavioral change communication to pregnant women are mandatory.

In 2015, the Chinese government implemented referral reform in its hierarchical medical system by adjusting the reimbursement rules of medical insurance, in order to guide patients\' hospital preference. This reform has impacted the equity and spatial accessibility of healthcare resources in different regions. Taking Beijing as a case study, we calculated and compared the equity and accessibility of healthcare resources before and after referral reform with a three-stage two-step floating catchment area method. We set different referral rates and explored their effects on medical service accessibility and equity. The results showed that the referral reform improved total accessibility of public hospitals in Beijing, but at the same time aggravated the inequality of healthcare resource accessibility among towns and streets. Healthcare accessibility demonstrated a U shape with an increase in referral rates. After testing five scenarios, we conclude that a 90% referral rate from the secondary hospitals to tertiary hospitals could be a trade-off when the government strikes a balance between equal chance of access to health services and high accessibility.

OBJECTIVE: The main objective of the study is to measure the satisfaction of OPD (Outpatient Department) patients in public health facilities of Madhya Pradesh in India.
METHODS: Data were collected from OPD patients through pre-structured questionnaires at public health facilities in the sampled eight districts of Madhya Pradesh. The data were analyzed using SPSS.
METHODS: Outpatient Departments of district hospital, civil hospital, community health centre, and primary health centre of the eight selected districts of Madhya Pradesh.
RESULTS: A total of 561 OPD patients were included in the study to know their perceptions towards the public health facilities, choosing health facility, registration process, basic amenities, perception towards doctors and other staff, perception towards pharmacy and dressing room services. It was found that most of the respondents were youth and having low level of education. The major reason of choosing the public health facility was inexpensiveness, infrastructure, and proximity of health facility. Measuring patient satisfaction were more satisfied with the basic amenities at higher health facilities compared to lower level facilities. It was also observed that the patients were more satisfied with the behavior of doctors and staff at lower health facilities compared to higher level facilities.