The aim of this work was to evaluate the Primary Health Care service performance in National
Tuberculosis Control Program in Gharbia Governorate.
Methods: The studied area (Gharbia Governorate) includes 8 health territories (each contains 5 primary
care units/centers). A questionnaire based on 6 parameters was used to evaluate the PHC system performance:
Methods: I – Physicians basic knowledge about TB (causative agent, methods of spread, clinical picture,
essential steps in investigations: X-ray and sputum smear), II – Facilities for primary investigation (sputum
examination and chest X-ray), III – Communication with the central health authorities or a TB specialist,
IV – Proper recording systems needed for proper patient management and follow up, V – Follow
up schedules available for the detected patients, VI – a role in community education about the disease.
The data obtained were tabulated and statistically analyzed.
Results: Studied area included 8 health territories and 40 primary care units (35% were urban and 65%
rural) with one physician in each unit. The mean percent of the correct answers of the basic knowledge
score was 49.6% (range = 18%–91%), it was higher in urban units physicians than rural units physicians,
with lack of proper laboratory (for sputum analysis) or X-ray apparatus. Communication with central
health authorities in urban areas was higher than rural areas (71.4% versus 61.5%). Case recording was
lower in urban than rural areas (28.6% versus 73.1%). Patient follow up after referral to central health
units was higher in rural than urban areas (11.5% versus 7.1%). Participation of community education
was 78.6% in urban units and 69.2% in rural units.
Conclusion: In Gharbia Governorate, PHC physicians lack proper knowledge about TB and their units lack
proper equipments (Lab and CXR). The PHC system needs to be empowered by the health care authorities
through training and equipments for better performance in NTP.
2017 The Egyptian Society of Chest Diseases and Tuberculosis. Production and hosting by Elsevier B.V.
This is an open access article under the CC BY-NC-ND license |
