Abstract:
Abstract
Globally, the emergency of Multidrug-Resistant Tuberculosis has become a major public health
problem in many countries and an obstacle to the global TB control efforts. Even if Ethiopia
continues to be among the HBC of MDR-TB in the world for a long time and still, the national
targets of MDR-TB control were not achieved. Improved quality of MDR-TB diagnosis and
treatment services helps to avert MDR-TB-related mortality and morbidity. Despite these facts,
the level of quality of service is not known in hospital. Evaluation objective: To evaluate
Multidrug Resistances Tuberculosis services quality at treatment initiation centers in Addis
Ababa. Methods: A multiple case study design with a mixed data collection method was used
from March 30 to May 30; 2021. Based on the Donabedian structure-process–outcome model of
health care quality with formative evaluation approach was used for MDR-TB service quality. A
total of 225MDR TB clients were included by consecutive sampling techniques. Moreover, 36
client-provider interactions, 236 patient record completeness, six-month documents review, and
10key informants were included. Multi-variable regression analysis techniques were used.
Qualitative data were analyzed manually and presented as triangulation with the quantitative
results. Results: The overall MDR-TB service quality was 67.7 % which was fair in TICs.
Availability, compliances, and satisfaction rates were 67.1%, 60.7%, and 75.4% in TICs
respectively. Compliance of MDR-TB with national guidelines scored 56.4% and 64.4% in
SPSH and ALERT hospitals respectively. So it needs improvement in both treatments initiation
centers. The level of satisfaction for each TICs were 67.3% and 75% fair based on judgment
criteria for each hospital respectively. The overall satisfaction rate of MDR TB treatment
initiation centers in Addis Ababa was 70.7% with
