Healthcare workers’ acceptance of the integrated tuberculosise-COVID- 19 screening in central Java Private Hospitals, Indonesia

Abstract

Objective: COVID-19 pandemic has negatively impacted the diagnosis and management of tuberculosis (TB) cases, and TBeCOVID-19 integrated screening was introduced as a strategy to overcome these problems. This study determined the acceptability of the TBeCOVID-19 integrated screening by healthcare workers (HCWs) and its impact on achievement of the TB program. Methods: This was a mixed-method study with an embedded design. Data on hospital TB program coverage from the national TB information system for all Muhammadiyah and Aisyiyah Hospitals (MAHs) in Central Java were compared before and after the implementation of TBeCOVID-19 integrated screening. The informants consisted of HCWs from 21 MAHs in Central Java. Focus group discussions (FGDs) were carried out with 7 hospital TB, 19 emergency room, 10 outpatient, 6 inpatient, and 4 managerial staff. In-depth interview (IDIs) were also performed with the Technical Officer TB Recovery Head of the Muhammadiyah Center. All IDIs and FGDs were recorded, transcribed verbatim, and subjected to thematic analysis guided by the theoretical framework of acceptability (TFA). Result: Implementation of the TBeCOVID-19 integrated screening program led to an increase in the number of new TB case diagnoses at the Central Java Hospitals. Moreover, the program was acceptable based on seven indicators from TFA. Despite the obstacles faced by HCWs during the implementation process, the program still managed to meet the standards. Conclusion: Acceptance by HCWs is a critical factor in the successful implementation of programs, including the TBeCOVID-19 integrated screening. Furthermore, a multifaceted and cross-sectoral approach is required to address the constraints associated with the process.