Accessibility and TB patient satisfaction in Nigeria

Abstract

<sec><title>BACKGROUND</title>Nigeria ranks first in Africa and sixth among countries with a high Tuberculosis burden globally. The increasing incidence of drug resistance following poor treatment adherence among drug-susceptible TB (DS-TB) patients necessitates reviewing TB services in Nigeria. This study explored accessibility and patient-reported experiences in newly established TB treatment facilities.</sec><sec><title>METHODS</title>In this comparative cross-sectional analytic study, we administered the Patient Reported Experience Measure (PREM) questionnaire to 430 patients with DS-TB in 27 public and 18 private newly engaged facilities in Osun, Nigeria. Data were analysed using R Software.</sec><sec><title>RESULTS</title>Private facilities were more accessible ( n = 210, 97.2% vs n = 194, 90.7%; P = 0.004) and offered more satisfactory services ( n = 209, 96.8% vs n = 194, 90.7%; P = 0.009). More patients in public facilities could not afford transportation costs (52.6% vs 35.8%; P = 0.007), and payment for services was higher in private facilities ( P < 0.001). After adjusting for covariates, the odds of experiencing satisfactory services were 3.12 times higher in private facilities (OR 3.12, 95%CI 1.19–8.15). Time-to-facility, marital status, and facility type predict patients’ experience.</sec><sec><title>CONCLUSION</title>Private facilities were more accessible and offered more satisfactory services. National TB programmes should decentralise TB services to private facilities and address gaps in public facilities.</sec>