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Free Content Quality of tuberculosis care provided in different models of public-private partnerships in South Africa

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SETTING: Free State, North West and Western Cape provinces, South Africa.

OBJECTIVE: To evaluate quality of care for the treatment of tuberculosis (TB) provided in different public-private partnerships.

DESIGN: Quality of care analysis comparing three different models of directly observed treatment (DOT) provision: purely public, public-private workplace partnership (PWP), and public non-governmental organisation (NGO) partnership (PNP). For each type of provision model, two sites were selected. Three dimensions of quality of TB care—structure, process and outcome—were assessed.

RESULTS: The PWP sites had the highest score in all three aspects of quality of care. In terms of process quality, the sites achieved similar scores, reflecting a very good knowledge of the treatment guidelines for both private and public providers. Patients supervised in the public clinics generally had lower treatment completion rates than those supervised in the occupational health clinics in the workplace and in the community.

CONCLUSION: Partnerships with community-based NGOs and employer-based medical services should be established when the government does not have the capacity to provide services. The capacity of the public sector to monitor the quality of care provided in the partnerships is therefore crucial.
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Keywords: South Africa; private providers; public-private partnerships; quality of care; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Health Economics Unit, School of Public Health & Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, South Africa 2: Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom

Publication date: 01 July 2006

More about this publication?
  • 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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