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Table 1 Healthcare provider-reported facilitators of and barriers to integrated COVID-19 and TB screening at Kiruddu National Referral Hospital, Kampala, Uganda

From: Integration of COVID-19 and TB screening in Kampala, Uganda: healthcare provider perspectives

Potential facilitators

Potential barriers

TB focal persons are available to support healthcare providers to provide integrated screening for TB and COVID-19

“… Just like we have the TB focal persons that are already in existence. We have focal persons at the facility level, sub-health district, district, etc. The focal persons will support HCP to provide integrated screening for TB and COVID-19.” (Medical Officer at the hospital) (Nurse at the hospital)

Healthcare providers lacked adequate knowledge on how to integrate screening of TB and COVID-19

“My experience in screening TB in the presence of COVID-19 is that sometimes you may not be sure whether you are dealing with TB or COVID-19. Because the presentations are a bit similar…but where we have some doubts, we have been referring those clients for COVID-19 testing.” (Nurse at the hospital)

Healthcare providers also suggested that utilizing the already existing training forums at the health facility would strengthen the capacity of HCP to integrate COVID-19 and TB screening.

“…... you will have to use existing workshops or mentorships and training for all the health workers to integrate COVID-19 and TB screening.” (Medical Doctor at the hospital)

Lack of simple standard operating procedures for integrated screening of TB and COVID-19

“If you have a very tedious tool for screening, they (HCP) may not do it because it consumes a lot of time. But if it is a simplified tool then it can be well utilized, it is easier to use.” (Medical Officer at the hospital)

 

Lack of consistent supply of personal protective equipment (PPE)

“If the government can equip the hospital with equipment like sanitizers, temperature guns, PPE. I think it would help health workers accept because they will know that at least our health is well protected (Nurse at the hospital)

 

Understaffing at the outpatient and emergency departments

“We are still understaffed in most places because you have two nurses treating patients on the whole floor or level and yet they want to remove one nurse and take her somewhere else.” (Medical Officer at the hospital)

 

Healthcare providers fear contracting COVID-19 infection during integrated screening

“Anything to do with COVID-19, I don’t want to know, even the ones we are working with [health workers], if she reads a file and sees the word COVID-19 anywhere, that patient may not be seen and may not or delay to receive treatment”. (Nurse at the hospital)

 

Lack of risk allowance for healthcare providers to conduct integrated screening of TB and COVID-19

“..Of course, people need allowances, without allowances they are not going to …actually for us we do not have COVID allowances at this hospital, because they say we don’t treat COVID because COVID is in the communities yet we treat COVID here. That one of the factors that limit health workers involved in screening for COVID, screening for both can be there so no problem but COVID mostly health workers are not interested.” (Medical Officer at the hospital)

  1. Abbreviations: HCP healthcare providers, TB tuberculosis, PPE personal protective equipment