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Original Research

Int J Trop Med Public Health. 2012; 1(1): 11-29


AN ASSESSMENT OF PUBLIC PRIVATE MIX UNDER RNTCP IN DISTRICT SABARKANTHA, GUJARAT, INDIA

Chirag Damore, Rajesh NAIR and Sapna Sachdeva Nair.

Abstract
Background: India is the highest TB burden country accounting for one fifth (21%) of the global incidence. Global annual incidence estimate is 9.4 million cases out of which it is estimated that 2 million cases are from India. India is 17th among 22 High Burden Countries in terms of TB incidence rate. For prevention and control of tuberculosis Government of India launched phase –I of (Revised National Tuberculosis Control Programme) RNTCP from 1992 to 2006 and phase-II from 2006 to 2011. Public Private Mix (PPM) model has been defined by WHO as ‘strategies that link all entities within the private and public sector to the National TB program for DOTS expansion.’ The overall aim of study was to understand current implementation of Public Private Mix (PPM) strategy under RNTCP, its effect on new case notification and treatment outcomes for tuberculosis in Distt. Sabarkantha, Gujarat. The study further intended to assess the knowledge, attitude and practice of private practitioners (PPs) currently involved under the RNTCP. Method: A prospective cross-sectional study was conducted among PPs and NGOs from April to May, 2011 in district Sabarkantha. Private Practioners N=58 who were involved in PPM under RNTCP were approached for primary data collection. A self-administered questionnaire and FGD topic guide was used for data collection. Secondary data was obtained from District TB Office to assess the extent of PPs and NGOs involvement in RNTCP program. Results: In year 2010- 2011, out of total 344 New Sputum Positive (NSP) cases, 17(5 %) NSPs were from the cases referred by PPs through PPM model. Out of total 1505 patients put on DOTS, only 54 (4%) patients were put on DOTS by private providers during year 2010-2011. The data suggests that involvement of private providers is very low. In term of knowledge level among PPs, low to medium level of knowledge regarding DOTS (among 98% PPs) and regarding RNTCP guidelines low to medium level of DOTS practice (among 88% PPs)was found. 48% of PPs did have not attended any training or CME at least in last few year. Conclusion: Majority of study participants consider DOTS/ RNTCP as effective strategy, but extent of their involvement in RNTCP is abysmally limited. To saturate quality coverage of all TB cases, efficient identification of New Sputum Positives (NSPs) and treatment outcomes, it is pertinent to further strengthen the capacities of private practitioners under Public Private Mix model and develop cross referral linkages under RNTCP in district Sabarkantha, Gujarat.

Key words: RNTCP, Public Private Mix, Tuberculosis, DOTS, Private practitioners


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