Free Content Private GPs contribute to TB control in Myanmar: evaluation of a PPM initiative in Mandalay Division

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Abstract:

SETTING: Mandalay Division, Myanmar.

AIM: To assess the effect of an initiative to involve private general practitioners (GPs) in the National Tuberculosis Programme (NTP) and to identify lessons learnt for public-private mix scale-up.

METHODS: Source of referral/diagnosis and place of treatment were included in the routine recording and reporting systems to enable disaggregated analysis of the contribution of GPs to case notification and treatment outcomes. Case notification trends were compared between the intervention and control areas over a 4-year period.

RESULTS: Private GPs contributed 44% of new smear-positive cases registered during the study period (July 2002–December 2004). The notification of new sputum smear-positive TB in the study area increased by 85% between the year prior to the GP involvement and 2 years after (from 46 to 85/100000). Case notification increased by 57% in the control townships and by 42% in all of Mandalay Division. The treatment success rate for new smear-positive cases treated by GPs was 90%.

CONCLUSIONS: The involvement of private GPs substantially increased TB case notification, while a high treatment success rate was maintained. Success factors include a well-developed local medical association branch, strong managerial support, training and supervision by the public sector and provision of drugs and consumables free of charge by the NTP.

Keywords: Myanmar; case detection; public-private mix; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medical Research (Upper Myanmar), Pyin Oo Lwin, Myanmar 2: World Health Organization Country Office, Yangon, Myanmar 3: National Tuberculosis Programme (Upper Myanmar), Mandalay, Myanmar 4: Department of TB Strategy and Health Systems, Stop TB Department, World Health Organization, Geneva, Switzerland

Publication date: September 1, 2006

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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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