Evaluation of Policy for Active Case Finding of Tuberculosis in Prisons to Action in Health Region Area 3, 2017

Abstract

           The objective of this study was to evaluate the results of policy for active case finding of tuberculosis in prisons to action in health region area 3 2017. According to the public policy analysis concept. The design was descriptive study on two studied populations including 17 responsible staffs form regional and provincial levels and each prison of Nakhon Sawan, Kamphaengphet, Pichit, Uthai Thani and Chainat province together
with 755 prisoners from such provinces who showed positive findings of tuberculosis from chest x-ray pictures. Data was collected from November to December 2017 from designed questionnaire and relating documents and were analyzed by descriptive statistics. Results on evaluation of policy to action process revealed successful policies implantation on 1) Clarity of objectives of policy which resulted in complete coverage of screening by chest x-ray of every prisoners together with sputum examination and molecular biological test, 2) adequate financial supports, 3) collaboration among responsible staffs, 4) Complete coverage of 100 percent chest x-ray follow-up and confirmation by sputum examination which resulted in detection of 64 new cases of tuberculosis with detection-rate of 8.7 percent, 5) The prisoners were better
understanding on tuberculosis of 94.1 percent, responsible staffs and prisoners together with satisfaction of policies of 82.2 and 88.2 percent respectively. As for unsuccessful policy, implementation, they were problems of policy communication and transfer into responsible staffs, inadequate resource support and low coverage of only 11.5 percent of confirmation of positive sputum examination by Xpert MTB/RIF molecular biological test. Author has given recommendations in order to achieve elope effective policy to action.