Perception of Patients and Health Workers About Directly Observed Treatment Short Course (DOTS) Program Implementation in AL-Anbar Governorate

Abstract

Background:- DOTS Program is widely accepted as an essential strategy for achieving (TB) control. DOTS has been adopted by WHO as hopeful strategy for treatment of TB since early nineties. Iraqi health authorities started DOTS implementation since 2001 in Baghdad. Coverage expanded gradually till it reached 100% in 2003.Objectives:- This study aimed to assess the application of DOTS program in Al - Anbar governorate ,and to define obstacles that facing the implementation of this programPatient and Methods :-This Cross –Sectional TB patients and Health employees-based Study was conducted in consultation clinic in Ramadi City and Diagnostic units of Health Centres in Al-Anbar Governorate for the period of October 1 ,2012 to March 31,2013.Direct interviewing was applied by structured questionnaire , which consists of (10) ten questions to (200 TB patients) about the treatment application and their agreement with different aspects of care regarding DOTS program implementation was conducted. While a self-administered questionnaire was applied confidentially with a sample group involving (6o) health care providers for their satisfaction on all aspects of the implementation of DOTs program. Socio-demographic information for this convenient sample were also collected .Data were analysed using the Epi-Info statistical package. Frequency distribution and frequency rates were calculated ,and compared with other studies.Results: Out of 200 TB patients 51% were males, and 49% were females with male to female ratio 1.04:1,with a mean age of 28.4 ± 6.5 years ,and 28.5% of male patients were illiterate ,and two thirds of them were unemployed . The agreement result for subjected individuals to structured questionnaire revealed a low assessing score(39.8%) for daily supplying of medication , while social stigma facing subjected patients was of high assessing score(88.3%) ,followed by effect of the disease on work and monthly income was (86.6%) . However ,the satisfaction of 60 health workers regarding motivation with financial monthly income was low (52%) ,followed by satisfaction of Health education given to TB patients was (73.8%), while the overall mean satisfaction of the (60) health workers for the (10) questions was (78.35%) .Conclusions: Aalthough the proper follow up and health education are the cornerstone of TB management, there was no daily supply of medication to TB patients under supervision. Because of seriousness of the disease and low financial motivations, the health workers showed no desire to work in this program