Accessibility and TB patient satisfaction in Nigeria.

Abstract

Nigeria ranks first in Africa and sixth among countries with a high Tuberculosis burden globally. The increasing incidence of drug resistance following poor treatment adherence among drug-susceptible TB (DS-TB) patients necessitates reviewing TB services in Nigeria. This study explored accessibility and patient-reported experiences in newly established TB treatment facilities.In this comparative cross-sectional analytic study, we administered the Patient Reported Experience Measure (PREM) questionnaire to 430 patients with DS-TB in 27 public and 18 private newly engaged facilities in Osun, Nigeria. Data were analysed using R Software.Private facilities were more accessible (n = 210, 97.2% vs n = 194, 90.7%; P = 0.004) and offered more satisfactory services (n = 209, 96.8% vs n = 194, 90.7%; P = 0.009). More patients in public facilities could not afford transportation costs (52.6% vs 35.8%; P = 0.007), and payment for services was higher in private facilities (P < 0.001). After adjusting for covariates, the odds of experiencing satisfactory services were 3.12 times higher in private facilities (OR 3.12, 95%CI 1.19-8.15). Time-to-facility, marital status, and facility type predict patients' experience.Private facilities were more accessible and offered more satisfactory services. National TB programmes should decentralise TB services to private facilities and address gaps in public facilities..