Feasibility study of strengthening the public–private partnership for tuberculosis case detection in Bandung City, Indonesia

Lestari, Bony Wiem; Arisanti, Nita; Siregar, Adiatma Y. M.; Sihaloho, Estro Dariatno; Budiman, Gelar; Hill, Philip C.; Alisjahbana, Bachti; McAllister, Susan

doi:10.1186/s13104-017-2701-y

Cited by 15 publications

(27 citation statements)

References 18 publications

(20 reference statements)

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“… Suboptimal performance with 6% utilization Lack of time to use the system Technical/operational challenges Busy phone line/call interruptions Thu et al, 2020 A cohort study that involved the analysis of routine surveillance data of patients aged 15 and above attending the OPD for a period of six months in Vietnam Study duration : 6 months Participants : 110 TB cases A mobile application was used to reduce dropout in the care cascade and to enhance follow up care by community health workers To evaluate the performance of an innovative Private sector engagement model by tracking the cascade of TB care among individuals attending Haiphong International General Hospital (HIGH) Utilization Of the 299 patients who had suggestive TB symptoms, 110 total cases were notified through the application. Of the diagnosed cases, 105 (95%) were initiated on treatment and 97 (93%) had a successful treatment outcome The Mobile app enabled the notification of every TB case diagnosed by alerting the health care system to provide follow up care to patients thus reducing the initiation and completion Lestari et al, 2017 A Pilot study among private practitioners in Bandung city, Indonesia Study duration : 6 months Participants : 12 private practitioners and 36 TB symptomatic patients A mobile app for the notification of TB cases that enabled referral and report back system that utilized simplified versions of the NTP forms To evaluate the feasibility of the intervention package to increase TB case detection and notification rates among private practitioners in Indonesia Feasibility and Acceptability Of the 12 Private practitioners who successfully installed the app, only five (41.6%) registered patients with TB symptoms and cases into the app. 36 patients with TB symptoms were identified and 17 were confirmed TB positive.…”

Section: Methodsmentioning

confidence: 99%

A review of mobile health interventions for public private mix in tuberculosis care

Tumuhimbise

Musiimenta

2021

Internet Interventions

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Background The World Health Organization (WHO) recommends the use of mobile health (mHealth) technologies as emerging opportunities to closing the gaps in Tuberculosis (TB) care through enhancing Public Private Mix (PPM). However, little is known about mHealth interventions that have been used for enhancing PPM in TB care, those that worked and those that did not. Objective This review summarizes the published evidence on the utilization and effectiveness of mHealth interventions for public private mix in TB care from literature. Methods Google scholar, PUBMED, IEEE Xplore and ScienceDirect databases were searched for peer reviewed literature from 1st January 2003 to 31st December 2020 for studies about the mHealth interventions for public private mix in TB care. This was guided by the scoping review methodology proposed by Arksey and O′ Malley. In order to assess the quality of the selected studies, mHealth evidence reporting and assessment (mERA) checklist was utilized. Studies that discussed the utilization of mHealth interventions for implementing PPM in TB care were included. Nine studies met the inclusion criteria and were analyzed for review. Results The review found out the application of mHealth in Public Private Mix in TB care through the following ways; 1) TB screening, 2) TB case notification 3) TB treatment adherence 4) data collection and management 5) patient referral and follow up, and 6) education. This resulted into high user experience, significant time reduction in data aggregation, increased case notification and referrals and proactive tracking and provision of follow up care hence reduced treatment and completion gaps. One study yielded suboptimal utilization due to the technical and operational challenges encountered by the healthcare workers. Conclusion Although this scoping review highlights the role of mHealth technologies in enhancing PPM in TB care, its utilization is still limited in African settings. No Africa-based study was identified by this review. Future studies should focus on assessing the utilization of mHealth for PPM in Africa.

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Section: Methodsmentioning

confidence: 99%

A review of mobile health interventions for public private mix in tuberculosis care

Tumuhimbise

Musiimenta

2021

Internet Interventions

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“…Among the 870 TB cases diagnosed by these PPs, fewer than 20% were notified. In an earlier feasibility study, 12 we showed that 40% of participating PPs had inadequate knowledge of TB symptoms and/or signs. A digital application designed to assist with referral and notification was well received, utilized and showed potential to increase TB notifications, although not all PPs had phones that supported it.…”

mentioning

confidence: 80%

“…The educational material will cover not only clinical management of TB patients but also public health and regulatory aspects of TB, from TB identification, to provisional diagnosis and referral, how to use the mobile phone app, and strategies to improve communication and increase adherence. From the feasibility study, 12 we found that not all PPs have time to attend a 1-day training session; therefore, the education will be delivered as two 1-hour in-person sessions each separated 1-week apart (Table 1). We will do a follow-up visit, one month after the completed education, for every PP.…”

Section: Interventionmentioning

confidence: 99%

“…This system is a refinement of the previously developed electronic referral system using a mobile phone app compatible with both android and apple operating systems (Figure 3). 12 The system will enable essential data to be uploaded, consistent with the NTP forms, which includes patient identity, diagnostic examinations, TB type, and referral plan. Participating PPs will inform the patients that the clinic is participating in a study about a TB notification system, and that patient information will be relayed to the Ministry of Health as per the regulatory requirement.…”

Section: Interventionmentioning

confidence: 99%

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A public health intervention package for increasing tuberculosis notifications from private practitioners in Bandung, Indonesia (INSTEP2): A cluster-randomised controlled trial protocol

et al. 2021

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Background. A significant proportion of tuberculosis (TB) patients globally make their initial visit for medical care to either an informal provider or a private practitioner, and many are not formally notified. Involvement of private practitioners (PPs) in a public–private mix for TB (TB-PPM) provides an opportunity for improving TB control. However, context-specific interventions beyond public–private agreements and mandatory notification are needed. In this study we will evaluate whether a tailored intervention package can increase TB notifications from PPs in Indonesia. Methods. This is a cluster-randomized trial of a multi-component public health intervention. 36 community health centre (CHC) areas will be selected as study locations and randomly allocated to intervention and control arms (1:1). PPs in the intervention areas will be identified using a mapping exercise and recruited into the study if they are eligible and consent. They will receive a tailored intervention package including in-person education about TB management along with bimonthly electronic refreshers, context-specific selection of referral pathways, and access to a TB-reporting app developed in collaboration with the National TB programme. The primary hypothesis is that the intervention package will increase the TB notification rate. The primary outcome will be measured by collecting notification data from the CHCs in intervention and control arms at the end of a 1-year observation period and comparing with the 1-year pre-intervention. The primary analysis will be intention-to-treat at the cluster level, using a generalised mixed model with repeated measures of TB notifications for 1 year pre- and 1 year post-intervention. Discussion. The results from this study will provide evidence on whether a tailored intervention package is effective in increasing the number of TB notifications, and whether the PPs refer presumptive TB cases correctly. The study results will guide policy in the development of TB-PPM in Indonesia and similar settings.

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“…Public-private partnerships (PPP) have been implemented globally to improve access, care and support for TB patients accessing private health care. Many interventions have been evaluated for increase in case detection rates 18,19 and few for cost effectiveness 8 . Our end-line study undertaken in the two cities of Mumbai and Patna to evaluate the effect of a PPIA intervention on durations and delays in TB care is, to our knowledge, the first of its kind.…”

Section: Discussionmentioning

confidence: 99%

Effect of public-private interface agency in Patna and Mumbai, India: Does it alter durations and delays in care seeking for drug-sensitive pulmonary tuberculosis?

Shah

Rangan

et al. 2020

Gates Open Res

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Background: Public–private interface agency (PPIA) intervention models in Patna (E. India) and Mumbai (W. India) for pulmonary drug-sensitive (DS) tuberculosis (TB) patients were evaluated over 2 years after maturity to examine effect on reduction of patient pathways and retention. The models engaged private providers, diagnostic facilities and pharmacies into an effective network providing free diagnostic tests and treatment. Methods: A population-based retrospective study was undertaken to assess effectiveness of the PPIA model in care pathways of 64 (Patna) and 86 (Mumbai) patients through in-depth interviews conducted within 6 months of initiation treatments to identify types and facilities accessed, duration to diagnosis and treatment. Median durations based on facilities accessed were statistically analysed. Comparisons were made with baseline values and endline pathways of patients accessing PPIA engaged/non-engaged facilities in private and public sectors. Results: Compared to non-engaged facilities, persons accessing engaged facilities at first point-of-care had shorter pathways (Mumbai: 32 vs 43 days), (Patna: 15 vs 40 days). Duration for first care-seeking was considerably shorter for patients accessing PPIA in Patna and for both engaged and non-engaged private facilities in Mumbai (4 days). Whilst PPIA engaged facilities diagnosed more cases than others, the RNTCP in Mumbai provided diagnosis early. There was good retention of patients by PPIA-engaged (1st) facilities (90% post-diagnosis in Patna) but this was affected by the hub-spoke referral system in Mumbai (13%). Second diagnosis is a common feature in Mumbai. The spoke-hub model in Mumbai contributed considerably to treatment delay; PPIA-engaged providers were better at retaining patients post treatment initiation 11/25 (44%). Conclusion: PPIA-engaged facilities, accessed at onset, result in marked reduction in pathway durations. Such initiatives should engage a critical mass of competent providers, proximal investigation facilities with enhanced disease awareness and literacy efforts amongst communities. Patient movement should be minimized for early treatment and retention.

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Feasibility study of strengthening the public–private partnership for tuberculosis case detection in Bandung City, Indonesia

Cited by 15 publications

References 18 publications

A review of mobile health interventions for public private mix in tuberculosis care

A review of mobile health interventions for public private mix in tuberculosis care

A public health intervention package for increasing tuberculosis notifications from private practitioners in Bandung, Indonesia (INSTEP2): A cluster-randomised controlled trial protocol

Effect of public-private interface agency in Patna and Mumbai, India: Does it alter durations and delays in care seeking for drug-sensitive pulmonary tuberculosis?

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