Assessment of Enablers’ Support Package in Tuberculosis Treatment in Central Region of Ghana

Abstract

Introduction: Tuberculosis (TB) is a disease of public health importance, affecting over 10 million people globally in a year. The TB disease is the single largest cause of mortality relative to communicable disease globally. TB treatment success rates have been below the WHO target of at least 85% while defaulter and failure rates have been higher than the national average since 2015 in Central Region. Ghana introduced a nationwide financial incentive known as the enablers’ package for TB patients, treatment supporters and health care providers in 2006 to ensure treatment adherence and better TB treatment outcomes. Enablers’ support package is currently benefitting only MDR-TB patients. Objective: The objective of the study was to assess the contribution of the enablers’ package to TB treatment success in the Central Region of Ghana. Methods: A cross-sectional analytical study was used. Records of TB patients from the district TB register were reviewed from 2012-2017. Pearson’s chi square test to test for associations between the dependent variable and independent variables, and multiple logistic regression analysis was used to determine the predictors of TB treatment success. Two-sample test of proportions was used to compare the proportion of TB treatment success rates between TB patient groups while propensity-score matching was used to estimate the contribution of the enablers’ package to treatment success between the two groups. Stata was used for the data analysis with level of significance at p<0.05 Results: Records of 2,127 TB patients were reviewed in the five districts and 98.1% (2,087/2127) of them met the inclusion criteria. About 64% (1339/2087) of the patients were males and 56% (1166/2087) of them lived in rural areas. Nearly 94% (1957/2087) of the patients were new cases. About 64% of the TB patients adhered to treatment whilst overall treatment success rate was 84%. TB patients who received enablers’ package had marginal better treatment success (84.3%). The enablers’ package contributed about 12.7% to TB treatment success in the Central Region. Conclusion: The financial enablers’ package contributed to the TB treatment success rates in the Central Region. Government and stakeholders should find sustainable sources of funding for TB control activities in the region and country.