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Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china

BACKGROUND: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified a...

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Autores principales: Wei, Xiaolin, Zou, Guanyang, Zhang, Hui, Li, Renzhong, Walley, John D, Jiang, Shiwen, Yin, Jia, Jin, Shuigao, Li, You, Sun, Qiang, Newell, James N, Griffiths, Sian, Wang, Lixia
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048529/
https://www.ncbi.nlm.nih.gov/pubmed/21324106
http://dx.doi.org/10.1186/1471-2458-11-103
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author Wei, Xiaolin
Zou, Guanyang
Zhang, Hui
Li, Renzhong
Walley, John D
Jiang, Shiwen
Yin, Jia
Jin, Shuigao
Li, You
Sun, Qiang
Newell, James N
Griffiths, Sian
Wang, Lixia
author_facet Wei, Xiaolin
Zou, Guanyang
Zhang, Hui
Li, Renzhong
Walley, John D
Jiang, Shiwen
Yin, Jia
Jin, Shuigao
Li, You
Sun, Qiang
Newell, James N
Griffiths, Sian
Wang, Lixia
author_sort Wei, Xiaolin
collection PubMed
description BACKGROUND: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. METHODS: Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. RESULTS: Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. CONCLUSION: Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study.
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spelling pubmed-30485292011-03-05 Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china Wei, Xiaolin Zou, Guanyang Zhang, Hui Li, Renzhong Walley, John D Jiang, Shiwen Yin, Jia Jin, Shuigao Li, You Sun, Qiang Newell, James N Griffiths, Sian Wang, Lixia BMC Public Health Research Article BACKGROUND: In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs) to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB) treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. METHODS: Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. RESULTS: Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. CONCLUSION: Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better results. However, standards and quality of TB care needed to be improved. The MC policy needs to be reviewed in light of evidence from this study. BioMed Central 2011-02-15 /pmc/articles/PMC3048529/ /pubmed/21324106 http://dx.doi.org/10.1186/1471-2458-11-103 Text en Copyright ©2011 Wei et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wei, Xiaolin
Zou, Guanyang
Zhang, Hui
Li, Renzhong
Walley, John D
Jiang, Shiwen
Yin, Jia
Jin, Shuigao
Li, You
Sun, Qiang
Newell, James N
Griffiths, Sian
Wang, Lixia
Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
title Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
title_full Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
title_fullStr Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
title_full_unstemmed Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
title_short Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
title_sort evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048529/
https://www.ncbi.nlm.nih.gov/pubmed/21324106
http://dx.doi.org/10.1186/1471-2458-11-103
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