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Free Content Feasibility and effectiveness of a public-private mix project for improved TB control in Delhi, India

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Abstract:

SETTING: New Delhi, India.

OBJECTIVE: To assess the feasibility of a public-private mix (PPM) project for improved tuberculosis (TB) control and determine its impact on case detection, case-management quality, treatment outcome and patient convenience.

DESIGN: 1) Monitoring of case detection through the review of record data; 2) cohort analysis of patients treated by private providers (PPs); 3) questionnaire-based surveys of patients and private providers.

RESULTS: A total of 612 cases were detected, of whom 168 (27%) were new sputum-positive cases. Incremental case notification due to PPs was 47% for new cases and 29% for new sputum-positive cases. Sputum examination for diagnosis and evaluation was performed in 100% and 84%, respectively, of notified patients. The treatment success rate for new sputum-positive cases treated by PPs was 81%, which was not significantly different from the 86% in the public sector. Directly observed treatment (DOT) was confirmed by 95% of patients.

CONCLUSIONS: This PPM project, carried out with government funding in accordance with the RNTCP recommendations and with the support from several government and private organisations, achieved improved case detection as well as acceptable treatment outcome for patients receiving DOT from PPs.

Keywords: private health care; private providers; public-private mix; tuberculosis

Document Type: Regular Paper

Affiliations: 1: LRS Institute of Tuberculosis and Allied Diseases, New Delhi, India 2: Department of Social Medicine, Göteborg University, Göteborg, Sweden 3: Nordic School of Public Health, Göteborg, Sweden

Publication date: December 1, 2003

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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