A survey to assess the extent of public-private mix DOTS in the management of tuberculosis in Zambia : original research

• Published in: African journal of primary health care & family medicine 2015-01, Vol.7 (1), p.1-7
• Main Authors: Kapata, Nathan, Chongwe, Gershom, Babaniyi, Olusegun, Maboshe, Mwendaweli, Michelo, Charles
• Format: Article
• Language: English
• ISSN: 2071-2928; 2071-2936
• DOI: 10.4102/phcfm.v7i1.692

Background: Involving all relevant healthcare providers in tuberculosis (TB) management through public-private mix (PPM) approaches is a vital element in the World Health Organization's (WHO) Stop TB Strategy. The control of TB in Zambia is mainly done in the public health sector, despite the high overall incidence rates. Aim: We conducted a survey to determine the extent of private-sector capacity, participation, practices and adherence to national guidelines in the control of TB. Setting: This survey was done in the year 2012 in 157 facilities in three provinces of Zambia where approximately 85% of the country's private health facilities are found. Methods: We used a structured questionnaire to interview the heads of private health facilities to assess the participation of the private health sector in TB diagnosis, management and prevention activities. Results: Out of 157 facilities surveyed, 40.5% were from the Copperbelt, 4.4% from Central province and 55.1% from Lusaka province. Only 23.8% of the facilities were able to provide full diagnosis and management of TB patients. Although 47.4% of the facilities reported that they do notify their cases to the National TB control programme, the majority (62.7%) of these facilities did not show evidence of notifications. Conclusion: Our results show that the majority of the facilities that diagnose and manage TB in the private sector do not report their TB activities to the National TB Control Programme (NTP). There is a need for the NTP to improve collaboration with the private sector with respect to TB control activities and PPM for Directly Observed Treatment, Short Course (DOTS). Une étude pour évaluer l'étendue des DOTS combinés publics-privés dans la gestion de la tuberculose en Zambie. Contexte: La participation de tous les professionnels de santé concernés dans la gestion de la tuberculose (TB) par une approche combinée publique-privée (PPM) est un élément capital de la Stratégie « Halte à la Tuberculose (TB) » de l'Organisation mondiale de la Santé (OMS). Le contrôle de la tuberculose en Zambie se fait principalement dans le secteur de la santé publique, malgré le taux d'incidence global élevé. Objectif: Nous avons mené une enquête pour déterminer l'importance de la capacité, participation, pratiques et adhésion du secteur privé aux directives nationales pour le contrôle de la tuberculose. Cadre: Cette enquête a été faite en 2012 dans 157 établissements de santé dans trois provinces de la Zambie oú se