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


METHODS
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.
Arora
V K
VK
LRS Institute of Tuberculosis and Allied Diseases, Sri Aurbindo Marg, New Delhi, India. lrsinet@bol.net.in
Sarin
R
R
Lönnroth
K
K
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration*; D003906:Developing Countries; D023801:Directly Observed Therapy; D005240:Feasibility Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008875:Middle Aged; D017149:Private Sector / Q000458:organization & administration*; D016730:Program Development; D015397:Program Evaluation; D017150:Public Sector / Q000458:organization & administration*; D011787:Quality of Health Care; D018570:Risk Assessment; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy*; D014944:World Health Organization