Evaluation of primary health care service participation in the National Tuberculosis Control Program in Menofya Governorate

To evaluate the primary health care (PHC) services performance in National Tuberculosis Control Program (NTP) in Menofya Governorate this study was created.MethodsA 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.ResultsThe 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%).ConclusionIn 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.