Engaging Private Health Care Providers to Identify Individuals with TB in Nepal

Rajesh Sah, Upendra Kumar Singh, Ranju Mainali, Ataulhaq Sanaie, Tripti Pande, Nathaly Aguilera Vasquez and Amera Khan
Additional contact information
Rajesh Sah: Save the Children International, Bardibas 45701, Nepal
Upendra Kumar Singh: Sahayog Samittee Nepal, Kalaiya 44412, Nepal
Ranju Mainali: Sahayog Samittee Nepal, Kalaiya 44412, Nepal
Ataulhaq Sanaie: Independent Consultant, London E11 4DP, UK
Tripti Pande: McGill Knowledge Management, McGill International TB Center, Montreal, QC H3G 1A4, Canada
Nathaly Aguilera Vasquez: McGill Knowledge Management, McGill International TB Center, Montreal, QC H3G 1A4, Canada
Amera Khan: Stop TB Partnership, TB REACH—Innovations and Grant Team, 1218 Geneva, Switzerland

IJERPH, 2021, vol. 18, issue 22, 1-8

Abstract: In Nepal, 47% of individuals who fell ill with TB were not reported to the National TB Program in 2018. Approximately 60% of persons with TB initially seek care in the private sector. From November 2018 to January 2020, we implemented an active case finding intervention in the Parsa and Dhanusha districts targeting private provider facilities. To evaluate the impact of the intervention, we reported on crude intervention results. We further compared case notification during the implementation to baseline and control population (Bara and Siraha) notifications. We screened 203,332 individuals; 11,266 (5.5%) were identified as presumptive for TB and 8077 (71.7%) were tested for TB. Approximately 8% had a TB diagnosis, of whom 383 (56.2%) were bacteriologically confirmed (Bac+). In total, 653 (95.7%) individuals were initiated on treatment at DOTS facilities. For the intervention districts, there was a 17%increase for bacteriologically positive TB and 10% for all forms TB compared to baseline. In comparison, the change in notifications in the control population were 4% for bacteriologically positive, and ?2% all forms. Through engagement of private sector facilities, our intervention was able to increase the number of individuals identified with TB by over 10% in the Parsa and Dhanusha districts.

Keywords: tuberculosis; private health care providers; public private mix (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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