title: Equity and the Sun Quality Health Private Provider Social Franchise: comparative analysis of patient survey data and a nationally representative TB prevalence survey.
abstract: BACKGROUND
  Since 2004, the Sun Quality Health (SQH) franchise network has provided TB care in Myanmar through a network of established private medical clinics. This study compares the wealth distribution of the TB patients to non-TB patients to determine if TB is most common among the poor, and compares the wealth of all TB patients to SQH TB patients to assess whether the franchise achieves its goal of serving the poor.
  
  
  METHODS
  The study uses data from two sources: 1) Myanmar's first nationally representative TB prevalence study conducted in 2009, and 2) client exit interviews from TB patients from SQH clinics. In total, 1,114 TB-positive individuals were included in the study, including 739 from the national sample and 375 from the SQH sample.
  
  
  RESULTS
  TB patients at SQH clinics were poorer than TB-positive individuals in the overall population, though not at a statistically significant level (p > 0.05). After stratification we found that in urban areas, TB patients at SQH clinics were more likely to be in the poorest quartile compared to general TB positive population (16.8% vs. 8.6%, respectively; p < 0.05). In rural areas, there was no statistically significant difference between the wealth distribution of SQH clinic patients and general TB positive individuals (p > 0.05).
  
  
  CONCLUSIONS
  Franchised clinics in Myanmar are reaching poor populations of TB patients in urban areas; more efforts are needed in order to reach the most vulnerable in rural areas.
authors.affiliation: Global Health Group, University of California San Francisco, San Francisco, CA, USA. montagud@globalhealth.ucsf.edu
authors.forename: Dominic
authors.initials: D
authors.lastname: Montagu
authors.forename: May
authors.initials: M
authors.lastname: Sudhinaraset
authors.forename: Thandar
authors.initials: T
authors.lastname: Lwin
authors.forename: Ikushi
authors.initials: I
authors.lastname: Onozaki
authors.forename: Zaw
authors.initials: Z
authors.lastname: Win
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D002052:Myanmar; D015995:Prevalence; D011331:Private Practice / Q000191:economics / Q000706:statistics & numerical data*; D012424:Rural Population; D040241:Social Marketing; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000191:economics / Q000453:epidemiology*; D014505:Urban Population; D055815:Young Adult