Assessing Implementation Outcomes of Joint TB/HIV Control Programme in the Accra Metropolis: A Qualitative Study

Abstract

Introduction: Tuberculosis (TB) has been identified to be a leading cause of early death among People Living with HIV (PLHIV) in sub-Saharan Africa (SSA) and HIV has emerged as one of the key factors hindering global TB control. In SSA, although there are many HIV/TB intervention programmes, structural, contextual and individual factors prevent targets from being met. In Ghana, collaborative HIV/TB services have been incorporated into health services since 2007. However, targets are not being met. Evaluating interventions through assessment of implementation outcomes has thus become necessary. Objective: The main objective of this study is to explore implementation outcomes of joint HIV/TB treatment programme in the Accra Metropolis in the Greater Accra Region o of Ghana. Methods: Key Informant Interviews (KII) were conducted for staff of National TB Control Programme (NTP) and the Ghana AIDS Control Programme (NACP). In-depth interviews (IDIs) were also conducted for clients attending HIV and TB clinics and health workers providing HIV and TB services. Interviews were conducted with a semi-structured interview guide. NVivo qualitative data analysis software was used to analyze data by generating themes based on study objectives. Results: Policy makers were of the view that the joint HIV/TB programme could sustainable. Challenges to fidelity identified by service providers were lack of funds, defaulting of clients and poor infrastructure. Clients were satisfied with care. However, lack of enablers, stigma and financial constraints are threats to retention in care. Conclusion: Inadequate funds, lack of human resource and stigma are major threats to implementation success of Ghana‘s joint HIV/TB programme.