Engaging Informal Private Health Care Providers for TB Case Detection: Experiences from RIPEND Project in India.

Tuberculosis Research and Treatment Pub Date : 2021-06-22 eCollection Date: 2021-01-01 DOI:10.1155/2021/9579167
Santosha Kelamane, Srinath Satyanarayana, Sharath Burugina Nagaraja, Vikas Panibatla, Ramesh Dasari, Rajeesham, Amera Khan, Vishnuvardhan Kamineni
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引用次数: 5

Abstract

Background: Informal (unqualified) health care providers are an important source of medical care for persons with presumptive TB (PPTB) in India. A project (titled RIPEND) was implemented to engage informal providers for the identification of PPTBs and TB patients in 4 districts of Telangana State, India, during October 2018-December 2019 project period. Engagement involved sensitizing the informal providers about TB, providing them financial incentives to identify PPTBs, and linking these PPTBs to diagnostic and treatment services provided by the Government of India's National TB Elimination Programme.

Objectives: To describe (a) the characteristics of the informal providers, along with their self-reported practices on TB diagnosis, treatment, and challenges encountered by the RIPEND project staff in engaging them in the project and (b) the outputs and outcomes of this engagement.

Methods: We used a combination of one-on-one interviews with informal providers, group interviews with RIPEND project staff, and secondary analysis of data available within the project's recording and reporting systems.

Results: A total of 555 informal providers were actively engaged under the project. The majority (87%) had a nonmedicine-related graduate degree and had been providing medical care for more than 10 years. Most (95%) were aware that a cough for 2 weeks or more is a symptom of pulmonary TB and that such patients should be referred for sputum-smear microscopy at a government health facility. Challenges in engaging the informal providers included motivating them to participate in the study, suboptimal mobile usage for referral services, and delays in providing financial incentives to them for referring PPTBs. During the project period (October 2018-December 2019), 8342 PPTBs were identified of which 1003 TB patients were detected and linked to TB treatment services.

Conclusion: This project showed that engaging informal providers is feasible and that a large number of PPTB and TB patients can be identified through this effort. The Government of India should consider engaging informal providers for the early diagnosis of TB to reduce the missing TB cases in the country.

让非正式私人卫生保健提供者参与结核病病例检测:来自印度RIPEND项目的经验。
背景:非正式(不合格)卫生保健提供者是印度推定结核病(PPTB)患者医疗保健的重要来源。在2018年10月至2019年12月的项目期间,在印度特伦甘纳邦的4个地区实施了一个名为RIPEND的项目,让非正式提供者参与识别pptb和结核病患者。参与包括提高非正式提供者对结核病的认识,向他们提供财政激励以确定pptb,并将这些pptb与印度政府的国家结核病消除规划提供的诊断和治疗服务联系起来。目的:描述(a)非正式提供者的特征,以及他们在结核病诊断、治疗方面的自我报告做法,以及RIPEND项目工作人员在让他们参与项目时遇到的挑战,以及(b)这种参与的产出和结果。方法:我们结合了与非正式提供者的一对一访谈,与RIPEND项目工作人员的小组访谈,以及对项目记录和报告系统中可用数据的二次分析。结果:共有555名非正式提供者积极参与了该项目。大多数(87%)拥有非医学相关的研究生学位,并且从事医疗服务超过10年。大多数人(95%)知道咳嗽2周或更长时间是肺结核的症状,这类患者应转诊到政府卫生机构进行痰涂片镜检。参与非正式提供者的挑战包括激励他们参与研究,转诊服务的移动使用不理想,以及延迟向他们提供转诊pptb的经济激励。在项目期间(2018年10月至2019年12月),发现了8342例pptb,其中1003例结核病患者被检测并与结核病治疗服务联系起来。结论:该项目表明,让非正式提供者参与是可行的,通过这一努力可以识别出大量PPTB和结核病患者。印度政府应考虑让非正式提供者参与结核病的早期诊断,以减少该国的遗漏结核病病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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