Degefa, M.G., Bezabih, A.M., Kahsay, Z.H. et al. Barriers and facilitators of nutrition assessment, counseling, and support for tuberculosis patients: a qualitative study. BMC Nutr 7, 58 (2021). https://doi.org/10.1186/s40795-021-00463-x
Barriers and facilitators of nutrition assessment, counseling, and support for tuberculosis patients : a qualitative study
|Author:||Degefa, Meaza Girma1; Bezabih, Afework Mulugeta2; Kahsay, Znabu Hadush3;|
1Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
2Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
3Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
4School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
5Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
6Biocenter Oulu, University of Oulu, Oulu, Finland
|Online Access:||PDF Full Text (PDF, 0.6 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2021111755753
|Publish Date:|| 2021-11-17
Background: Nutrition has a substantial role in the prevention, treatment, and cure of tuberculosis. Thus, nutrition assessment, counseling, and support (NACS) have been implemented as part of tuberculosis treatment. However, evidence on the barriers and facilitators (enablers) of its implementation is lacking.
Objective: To explore barriers and facilitators of implementation of NACS for tuberculosis patients.
Methods: An exploratory qualitative study was conducted in public health facilities and health offices of Mekelle City, Northern Ethiopia. We conducted 17 interviews using purposively selected key informants comprising health professionals (n = 12) and tuberculosis patients (n = 5). Interviews were tape-recorded, transcribed verbatim, and coded and analyzed using a thematic approach in ATLAS.ti 7 software.
Results: Barriers were identified at three levels -organization, care provider, and patient levels. Suboptimal nutritional supply, lack of supportive supervision, lack of adequate workforce, staff turn-over, the sudden withdrawal of partners, and weak link with social service were the barriers at the organization level. Lack of commitment was reported as the only barrier at the care provider level, and socioeconomic status of patients, sharing and selling of supplies, perceived improved status, and perceived stigma were identified as the major barriers for the implementation of nutrition assessment, counseling, and support service. While training, availability of measurement and educational tools, the inclusion of nutrition indicators in the tuberculosis register, and the presence of collaborating partners were identified as facilitators at the organizational level. Patients’ motivation to know their health status was reported to be a facilitator at the patient level.
Conclusions: Organization, care provider, and patient-level barriers and facilitators were found to influence the implementation of NACS. Hence, multilevel factors should be considered to successfully implement the program and to gain its potential impact.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3142 Public health care science, environmental and occupational health
This study was funded by Mekelle University-Norwegian university for life sciences in Norway (MU-NMBU) (project no. PG/MSc/CHS/MU-NMBU/33/2011). The findings and conclusions in this presentation are those of the authors and should not be construed to represent the funders.
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