TITLE:
Strategic Engagement of Private Facilities to Increase Public-Private Mix (PPM) Contribution to Nigeria Tuberculosis Case Notification
AUTHORS:
Obioma Chijioke-Akaniro, Emperor Ubochioma, Amos Omoniyi, Oluwafunmilayo Omosebi, Olawumi Olarewaju, Mary Etolue, Sunday Asuke, Elias Aniwada, Anyaele Uwaezuoke Ndubuisi, Victor Ombeka, Aderonke Agbaje, Adebola Lawanson, Chukwuma Anyaike
KEYWORDS:
Strategic Engagement, Public-Private Mix, Case Notification, Tuberculosis, Nigeria
JOURNAL NAME:
Journal of Tuberculosis Research,
Vol.10 No.3,
August
25,
2022
ABSTRACT: Introduction: Finding the missing Tuberculosis (TB) cases remains
the single most important priority for TB control in Nigeria. Between 66% - 92%
of all cases of respiratory diseases including those with symptoms suggestive
of TB are first seen byprivate health providers. Dependable, quality
surveillance systems and notification are key roles in health services
delivery, particularly as it is related to
TB control. However, poor notification has been a challenge. This study was to
assess the contribution of the public private mix (PPM) to Nigeria Tuberculosis national case notification. Methods: It was a national cross-sectional
study. Data were extracted from the National database and reviewed. Private
facilities were engaged in 2017 and assessed over 2018-2020. Interventions included: enrolling private
practitioners (Private-For-Profit, Faith Based Organization, Private Medicine Vendors and Community Pharmacists),
engaging a private standalone Laboratory for Gene
Xpert testing within the network of private
facilities, use of Mobile App for easy screening and reporting,
instituting a HUB and spoke, and incentives to private providers for
participating. Each private provider had a customized approach. Trend analysis
was performed using Cochran-Armitage χ2 test for linear trends. Level of significance
was at a p value of Results: Total case notification increased from 104,904 cases in 2017 to 138,591 in 2020. There were 2.0%
increase in 2018, 13.0% in 2019 and 15.0% in 2020 (p ). PPM contribution to case notification
increased from 10,699 cases in 2017 to 12,625 in 2018, then 17,250 in
2019 and 38,865 in 2020. There were 18.0% increase in 2018, 36.6% in 2019 and
125.3% increase in 2020 (p ). Conclusion: Effective engagement of the private sector in TB control efforts in
Nigeria using a variety of approaches resulting in improved TB notification is
possible. The National TB Programme should engage all private practitioners
such that each practitioner will practice at least one TB service model.