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Table 1 Recommendations for improving TB infection control

From: Voices from the frontline: barriers and strategies to improve tuberculosis infection control in primary health care facilities in South Africa

TB Infection control practice How it can be improved
Managerial level
 What should be the District and Provincial Managers’ Role in improving TB infection control? 1. Ensure provision of material resources
2. Ensure policy clarity and implementation
3. Training/Mentoring and consultation to facilities
4. Provision of adequate human resources
5. Monitoring and Evaluation
6. Improve infrastructure and maintenance
 What possible incentives can be introduced for the good practice of TB infection control? 1. Award for TB focal person
2. Prize-giving for facility e.g. trophy
3. Counselling and occupational health support
Administrative level
 How can we promote the use of tissues/masks for patients? 1. Health education/group information sessions or videos
2. Provision of masks (in waiting area)
 How can we separate coughing from non-coughing patients? 1. Triage and fast-tracking
 How can we promote TB and HIV screening for HCWs? 1. Education on importance of screening
2. Routine screening by the occupational health nurse at central sick bay with record keeping
3. Incentives
4. Counselling
 What is the best format for TB infection control training? For HCWs:
1. Workshop training followed by in-service/practical training at facility
2. Mentoring
3. Refresher training
For patients
1. Facility videos to educate patients
2. Reading materials such as pamphlets for patients
Environmental level
 How can we ensure the windows are opened and kept open in waiting areas and consultation rooms? 1. Allocate open-window marshal/focal person
2. Utilise monitoring tool, i.e. window register
3. Patient education and engagement
4. Keep open window posters/stickers
 Personal protective equipment
 How can we promote the use of disposable (N95) respirators among HCWs? 1. Provide disposable (N95) respirators and fit test
2. Training/education
3. Ensure compliance/Discipline (written warning on record)
4. Ensure policy is carried out