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

Gigil Marme; Jerzy Kuzma; Peta-Anne Zimmerman; Shannon Rutherford; Neil Harris

doi:10.1071/PY24051

RESEARCH ARTICLE (Open Access)

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

Gigil Marme

^A ^* , Jerzy Kuzma ^A , Peta-Anne Zimmerman ^B , Shannon Rutherford ^C Neil Harris ^D

+ Author Affiliations

- Author Affiliations

^A Divine Word University, Faculty of Medicine and Health Sciences, P O Box 483, Madang Province, Papua New Guinea. Email: jkuzma@dwu.ac.pg

^B Griffith University, School of Nursing and Midwifery, G16 2.43, Gold Coast Campus, Gold Coast, Qld, Australia. Email: p.zimmerman@griffith.edu.au

^C Griffith University, School of Medicine and Dentistry – Public Health, G01 3.51, Gold Coast Campus, Gold Coast, Qld, Australia. Email: s.rutherford@griffith.edu.au

^D Griffith University, G40 8.49, Gold Coast Campus, Gold Coast, Qld, Australia. Email: n.harris@griffith.edu.au

^* Correspondence to: gmarme@dwu.ac.pg

Australian Journal of Primary Health 31, PY24051 https://doi.org/10.1071/PY24051

Submitted: 12 June 2024 Accepted: 5 May 2025 Published: 19 May 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

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.

Keywords: community health, healthcare workers, infection prevention and control, nominal group technique, Papua New Guinea, primary health services, rural health services, rural hospitals, TB control strategies, tuberculosis.

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