Factors affecting clinicians practices on Isoniazid preventive therapy provision to people living with HIV/Aids in Dar es salaam region, Tanzania

Abstract

ABSTRACT Background: Isoniazid preventive therapy (IPT) for People living with HIV (PLHIV) is a necessary public health intervention especially in developing countries where both TB and HIV are serious problem. Despite its efficacy and importance the trend of IPT provision rate among eligible PLHIV in Tanzania is consistently less than 10% for the past seven years since its establishment in 2010; this is far beyond the target set by the Global STOP TB plan which aimed to achieve 50% of eligible PLHIV to be provided IPT by 2015. Objectives: The main objective of this study was to determine factors affecting clinician’s practices on IPT provision in Dar es Salaam. Methodology: A mixed methods design was used. For quantitative method study participants were clinicians working in CTC’s providing IPT; and for qualitative method the study participants were CTC’S In-charges. Stratified sampling method was used to select participants for quantitative method while purposive sampling method was used to select participants for qualitative method. Self administered questionnaire was used as collection tool for quantitative method while In-depth interviews were used for qualitative method. All conversations in In-depth interview were audio recorded, transcribed verbatim and analyzed using thematic approach. Results: A total of 122 clinicians and 6 CTC’s In- charges participated in this research. Overall IPT coverage was 7.27%. Isoniazid stock-out, lack of modern TB diagnostic technology; lack of knowledge among clinicians, poor attitude towards IPT among clinicians, lack of trainings and motivation to clinicians; and uncoordinated supervision were founded as the main factors affecting clinicians practices on IPT provision to PLHIV. Conclusion: Implementation of IPT provision to PLHIV in Dar es Salaam is very low compared to the GLOBAL STOP TB targets. Inconsistent supply of Isoniazid, lack of knowledge on IPT among clinicians, lack of modern diagnostic technologies, lack of trainings and motivation to clinicians; and uncoordinated supervision were founded as major factors affecting clinician’s practices on IPT provision.