‘We are not aware of notification of tuberculosis’: A mixed‐methods study among private practitioners from western India

• Published in: The International journal of health planning and management 2021-07, Vol.36 (4), p.1052-1068
• Main Authors: Rupani, Mihir P., Shah, Chinmay J., Dave, Jigna D., Trivedi, Atul V., Mehta, Kedar G.
• Format: Article
• Language: English
• Subjects: ATS‐MECOR; Bar associations; Guidelines; Health administration; Incentives; India; Mixed methods research; National Tuberculosis Program; Notification; operational research; private physicians; private practice; Private sector; Social media; STCI guidelines; Tuberculosis
• ISSN: 0749-6753; 1099-1751
• DOI: 10.1002/hpm.3151

Background Implementing the Standards for tuberculosis care in India (STCI) guidelines in the private sector is vital. This study attempted to estimate the knowledge and practices regarding STCI guidelines among private practitioners and to explore the reasons and solutions for low tuberculosis (TB) notification rates. Methods We conducted a cross‐sectional study for assessing the knowledge and practices of the STCI guidelines among 100 full‐time allopathic private practitioners in Bhavnagar (in western part of India) from September 2018 to January 2019. Knowledge and practice were categorised as good or poor by assigning scores to the responses to a questionnaire based on the STCI guidelines. It was followed by two focus group discussions to explore the reasons and solutions for low notification rates of TB as perceived by private practitioners. Results Among the 100 private practitioners, 55% had good knowledge, and 41% had good practice regarding the STCI guidelines; 69% knew about the gazette notification of mandatory notification of TB, and 58% were notifying TB cases to the government. Lack of awareness about the process as well as incentives for notification, time constraints and infrequent visits by health workers were the main reasons perceived by private practitioners for not notifying TB cases to the government. The critical solutions suggested by them were creating awareness regarding the notification process as well as incentives, increasing health worker visits and use of social media for notification. Conclusion Only about half of private practitioners follow the STCI guidelines for TB care, and the notification rates are low in our setting. Regular sensitisation programs need to be arranged for private practitioners to create awareness on TB notification.