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Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods

OBJECTIVES: In Bangladesh, private healthcare is common and popular, regardless of income or area of residence, making the private sector an important player in health service provision. Although the private sector offers a good range of health services, tuberculosis (TB) care in the private sector...

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Autores principales: Zafar Ullah, Abu Naser, Huque, Rumana, Husain, Ashaque, Akter, Salma, Islam, Akramul, Newell, James Nicholas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Group 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532984/
https://www.ncbi.nlm.nih.gov/pubmed/23253871
http://dx.doi.org/10.1136/bmjopen-2012-001534
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author Zafar Ullah, Abu Naser
Huque, Rumana
Husain, Ashaque
Akter, Salma
Islam, Akramul
Newell, James Nicholas
author_facet Zafar Ullah, Abu Naser
Huque, Rumana
Husain, Ashaque
Akter, Salma
Islam, Akramul
Newell, James Nicholas
author_sort Zafar Ullah, Abu Naser
collection PubMed
description OBJECTIVES: In Bangladesh, private healthcare is common and popular, regardless of income or area of residence, making the private sector an important player in health service provision. Although the private sector offers a good range of health services, tuberculosis (TB) care in the private sector is poor. We conducted research in Dhaka, between 2004 and 2008, to develop and evaluate a public–private partnership (PPP) model to involve private medical practitioners (PMPs) within the National TB Control Programme (NTP)'s activities. Since 2008, this PPP model has been scaled up in two other big cities, Chittagong and Sylhet. This paper reports the results of this development, evaluation and scale-up. DESIGN: Mixed method, observational study design. We used NTP service statistics to compare the TB control outcomes between intervention and control areas. To capture detailed insights of PMPs and TB managers about the process and outcomes of the study, we conducted in-depth interviews, focus group discussions and workshops. SETTING: Urban setting, piloted in four areas in Dhaka city; later scaled up in other areas of Dhaka and in two major cities. FINDINGS: The partnership with PMPs yielded significantly increased case finding of sputum smear-positive TB cases. Between 2004 and 2010, 703 participating PMPs referred 3959 sputum smear-positive TB cases to the designated Directly Observed Treatment, Short-course (DOTS) centres, contributing about 36% of all TB cases in the project areas. There was a steady increase in case notification rates in the project areas following implementation of the partnership. CONCLUSIONS: The PPP model was highly effective in improving access and quality of TB care in urban settings.
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spelling pubmed-35329842013-01-04 Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods Zafar Ullah, Abu Naser Huque, Rumana Husain, Ashaque Akter, Salma Islam, Akramul Newell, James Nicholas BMJ Open Public Health OBJECTIVES: In Bangladesh, private healthcare is common and popular, regardless of income or area of residence, making the private sector an important player in health service provision. Although the private sector offers a good range of health services, tuberculosis (TB) care in the private sector is poor. We conducted research in Dhaka, between 2004 and 2008, to develop and evaluate a public–private partnership (PPP) model to involve private medical practitioners (PMPs) within the National TB Control Programme (NTP)'s activities. Since 2008, this PPP model has been scaled up in two other big cities, Chittagong and Sylhet. This paper reports the results of this development, evaluation and scale-up. DESIGN: Mixed method, observational study design. We used NTP service statistics to compare the TB control outcomes between intervention and control areas. To capture detailed insights of PMPs and TB managers about the process and outcomes of the study, we conducted in-depth interviews, focus group discussions and workshops. SETTING: Urban setting, piloted in four areas in Dhaka city; later scaled up in other areas of Dhaka and in two major cities. FINDINGS: The partnership with PMPs yielded significantly increased case finding of sputum smear-positive TB cases. Between 2004 and 2010, 703 participating PMPs referred 3959 sputum smear-positive TB cases to the designated Directly Observed Treatment, Short-course (DOTS) centres, contributing about 36% of all TB cases in the project areas. There was a steady increase in case notification rates in the project areas following implementation of the partnership. CONCLUSIONS: The PPP model was highly effective in improving access and quality of TB care in urban settings. BMJ Group 2012-12-18 /pmc/articles/PMC3532984/ /pubmed/23253871 http://dx.doi.org/10.1136/bmjopen-2012-001534 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
spellingShingle Public Health
Zafar Ullah, Abu Naser
Huque, Rumana
Husain, Ashaque
Akter, Salma
Islam, Akramul
Newell, James Nicholas
Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods
title Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods
title_full Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods
title_fullStr Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods
title_full_unstemmed Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods
title_short Effectiveness of involving the private medical sector in the National TB Control Programme in Bangladesh: evidence from mixed methods
title_sort effectiveness of involving the private medical sector in the national tb control programme in bangladesh: evidence from mixed methods
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532984/
https://www.ncbi.nlm.nih.gov/pubmed/23253871
http://dx.doi.org/10.1136/bmjopen-2012-001534
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