Background to the problem addressed
Busesa is a government rural Health Centre IV located in Iganga district offering a range of in and out-patient services ranging from MCH, TB, HCT, HIV prevention and treatment services including ART and community outreach services. ART services are offered once a week by a team of 13 health workers who equally share responsibilities in all other clinic departments. Following a training of some members of the team in quality improvement, the team embarked on identifying and prioritizing gaps in service delivery. TB assessment was one of the challenges faced by the clinic, and it was ranked the top priority problem.
Only 64 % of the clients seen on every clinic day could receive a complete TB assessment. 36% of clients seen in the clinic were not assessed for TB. The performance of the centre was far below the National target which is “100% of HIV positive clients should be assessed for TB at every visit” Our gap was 36%.
1. Lack of awareness about client assessment for TB especially by some of the staffs who had not been trained in comprehensive HIV care.
2. Failure to document TB status after assessment especially by the clinicians who are charged with recording in the clients’ ART/Care cards.
3. Some clinicians attributed failure to assess to the workload during the clinic days given the small manpower at that time.
This was followed by a gap/problem analysis whereby the clinic team through a series of meetings came up with strategies to ensure achievements of the National target of 100% assessment of HIV positive clients for Active TB.