Table 3.
Barriers against provision of IPT based on 6 WHO health system-related components
| Description | Number of respondents | Agree | Percentage (%) |
|---|---|---|---|
| 1. Leadership and governance-related | |||
| Not clear direction of IPT implementation by Bureau of TB | 99 | 76 | 77 |
| Not clear direction of IPT implementation by Bureau of AIDS | 97 | 75 | 77 |
| IPT implementation was not supported by some experts | 94 | 46 | 49 |
| No IPT due to lack of support from Northern Region CDC 10 | 93 | 32 | 34 |
| No IPT due to lack of support from Provincial Health Office | 94 | 30 | 32 |
| No IPT due to lack of support from hospital physician | 92 | 28 | 30 |
| No IPT due to lack of support from hospital director | 97 | 23 | 24 |
| Summary: No IPT due to a lack of clear nation policy for IPT implementation | 97 | 80 | 82 |
| 2. Service delivery-related | |||
| No IPT due to fear of poor adherence | 101 | 57 | 56 |
| No IPT due to difficulty with the administration of tuberculin skin test | 101 | 49 | 49 |
| No IPT due to lack of operation guidelines or details for IPT provision | 84 | 34 | 41 |
| No IPT due to PLWH refusing to take IPT | 99 | 32 | 32 |
| Summary: No IPT due to difficulty with service delivery of IPT | 102 | 58 | 57 |
| 3. Supplies and products-related | |||
| No IPT due to difficulty with managing Purified Protein Derivative (PPD) as it needs cold chain management | 97 | 69 | 71 |
| No IPT due to unavailability of PPD | 98 | 40 | 41 |
| No IPT due to lack of support for isoniazid drug | 99 | 15 | 15 |
| Summary: No IPT because of difficulties with supplies and products | 96 | 63 | 66 |
| 4. Health system financing-related | |||
| No IPT due to doubt about cost-effectiveness of IPT programme | 98 | 65 | 66 |
| No IPT due to lack of extra central budget support for IPT implementation | 100 | 63 | 63 |
| Summary: No IPT because of lack of health system financing | 98 | 61 | 62 |
| 5. Health information system-related | |||
| No IPT due to lack of monitoring and supervision from national bureaus of TB and AIDS | 99 | 62 | 63 |
| No IPT due to not having standard IPT form or report from national bureaus of TB and AIDS | 100 | 47 | 47 |
| Summary: No IPT due to problems relating to health information system | 100 | 61 | 61 |
| 6. Health workforce –related | |||
| No IPT due to lack of staff to monitor and evaluate IPT programme at national level | 100 | 79 | 79 |
| No IPT due to lack of training for HCW resulting in a lack of confidence in providing IPT | 100 | 51 | 51 |
| No IPT due to lack of clear responsibilities between HIV HCW’s and TB HCW’s | 101 | 42 | 42 |
| No IPT due to workload of HCW | 101 | 41 | 41 |
| Summary: No IPT due to difficulties relating to human resources | 101 | 60 | 60 |
Note: 1. Excluded 15 respondents from hospitals that reported inconsistent answers of IPT implementation.
2. The information in this table was obtained from the nurses in TB and HIV clinics only.