Abstract To evaluate the primary health care (PHC) services performance in National Tuberculosis
Control Program (NTP) in Menofya Governorate this study was created.
Methods: A questionnaire based on 6 parameters was used to evaluate the PHC system
performance: 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/recorded patients. VI – Role in
community education about the disease.
Results: The studied area included 10 health territories and 46 primary health care units (34.8%
were urban and 65.2% were rural) with one physician in each unit. The mean percent of the correct
answers of the basic knowledge score was 54.5% and was higher in rural units physicians than
urban units physicians. There were lack of proper facilities (laboratory for sputum analysis and
X-ray apparatus), and availability of DOTS in 32 units (69.6%). Communication with central
health authorities in urban areas and rural areas was nearly equal (87.5–86.7%). Case recording
was lower in urban than rural areas (6.25% vs. 43.3%). Patient follow up after referral to central
health units was higher in rural than urban areas (23.3% vs. 6.25%). Participation in community
education was higher in rural than urban areas (80% vs. 20%).
Conclusion: In the Menofya Governorate, PHC physicians lack proper knowledge about TB and
their units lack proper equipment. The PHC system needs to be empowered by the health care
authorities through training and equipment for better performance in NTP. |
