Health facilities capacity for tuberculosis diagnosis and treatment in Ethiopia

Introduction: Tuberculosis is one of the major public health challenges in Ethiopia. There are limited information on health facilities capacity to offer TB services at national level. The purpose of the study is to evaluate the capacity of health facilities to provide TB service and, its variations by type of health facilities and regions in Ethiopia. Methods: Data from the 2018 Ethiopian Service Availability and Readiness Assessment (SARA) survey were used. The data were collected from all regions of the country. The overall TB service readiness score was calculated by considering twelve TB tracer items. Mean availability was considered for measuring health facilities overall capacity to provide TB service. Multiple linear regression was done to assess the association of selected health facilities characteristics with overall readiness score. Result: A total of 632 health facilities were included in the analysis. Twenty six percent of the clinics provided TB diagnosis, treatment prescription, or treatment follow-up; 18% had national diagnosis t and 16% TB smear microscopy diagnostic mechanism. Hospitals had better capacity score (76%) than health centers (69%) and Clinics (13%). The overall TB service capacity score for urban facilities (60%) was higher than that of the rural (49%) health facilities (β = -0.13, 95% CI: -0.18, -0.08). Clinics (β = -0.59, 95% CI:-0.67, -0.52) had lower capacity score than hospitals. Facilities in Afar (β = -0.13, 95% CI: -0.23,-0.02), Amhara (β = -0.12, 95% CI: -0.19, -0.04), Oromiya (β = -0.12, 95% CI: -0.20 , -0.04) and Somali (β =-0.13, 95% CI: -0.23 , -0.03) regions had lower capacity score than facilities in the Tigray. Conclusion: Hospitals and health centers in Ethiopia had good capacity to provide TB service, however low capacity was observed in clinics. There was a significant regional heterogeneity on the capacity of health facilities for TB service diagnosis and treatment in Ethiopia. This is also detected by facility type and facility setting .TB service improvement interventions should focus on the clinics and the regions whose readiness score is low to ensure equityand its capacity.