Implementation of the Chinese national microscopy centre policy: health facility survey in Shandong Province

OBJECTIVE: In compliance with Chinese national policy, Shandong province set up microscopy centres (MCs) in one-third of all township hospitals where sputum smear microscopy is performed. We assessed the centres' performance and any factors influencing it. METHODS: A cross-sectional, structured, facility-based questionnaire survey was conducted in 2006, collecting data from all 113 counties with established MCs as well as tuberculosis (TB) routine reporting data from the county TB dispensary. RESULTS: One hundred and thirteen of 142 counties in Shandong had established 497 MCs. The centres identified 3.3% of smear-positive patients in the province. Sixty-six percentage of MCs did not identify any patients with TB; only 5% identified more than 10. Poor performance arose from low quality of staff training in township hospitals, but inappropriate geographical provision of services was the main cause of low additional case finding. CONCLUSION: The MC policy did not achieve its goal of improving TB case finding in Shandong.