Healthcare workers' perspectives on the implementation of tuberculosis infection prevention and control policy in rural Papua New Guinea

Abstract

Background: Tuberculosis (TB) infection prevention and control (TB-IPC) is recommended as an essential public health intervention to control TB transmission worldwide. Nonetheless, merely applying evidence-based prevention and control measures is often inadequate for effective TB prevention and treatment goals. This study examined healthcare workers' (HCWs') perceptions of strategies important for TB-IPC in primary healthcare (PHC) settings in Papua New Guinea. Methods: Using a nominal group technique, this study sought the views of a diverse range of HCWs (ranging from clinical, IPC personnel to policymakers) from national and subnational levels, and various provinces to prioritise TB-IPC guidelines implementation needs in practice. Group discussions were conducted with 51 HCWs, and encompassed quantitative and qualitative data collection techniques. Nine key strategies drawn from a preceding study and literature review were presented to participating HCWs, and from these, three significant strategies related to TB-IPC policy were identified as key priorities. Results: The participants recommended HCWs' capacity building on TB-IPC policy and strategy, improving PHC infrastructure, and increasing community awareness of TB as the most important strategies to improve TB-IPC practices. Conclusions: This study investigated the perceptions of diverse key HCWs of the implementation of TB-IPC guidelines in PHC settings in rural Papua New Guinea. The HCWs identified key strategies needed for effective TB-IPC practice in PHC to prevent TB transmission. This study supports previous recommendations that call for adopting multi-pronged strategies to improve the high TB burden. Key stakeholders' insights have been shared to inform public health policy and program implementation both locally and as part of the global goals of the TB eradication program.