Public-Private Mix for TB care and control
A tool for national situation assessment
In most countries with a significant burden of tuberculosis (TB), patients with symptoms of TB seek and receive care from a wide variety of providers, including those outside the network of national TB programmes (NTPs). These include private providers and public sector health care institutions outside the purview of the NTP. These providers frequently do not follow the recommended DOTS strategy for managing TB and hence the TB patients they serve are often deprived of the benefits of standard and rational treatment.
To address this weakness in global TB control, it has been envisaged that NTPs should develop public–private mix (PPM) programmes to involve all relevant health care providers in TB control. Considerable evidence on the implementation of PPM is now available from different countries, and has led to the preparation of a guidance document* by WHO’s Stop TB Department.
The guidance document underlines systematic steps to be taken by a NTP in implementing PPM, of which a national situation assessment (NSA) is the first. This tool has been prepared with support from the United States Agency for International Development's (USAID's) Tuberculosis Control Assistance Program (TBCAP) and should be used in conjunction with the guidance document. It suggests a plan for conducting a NSA through a process of consultation and knowledge management. The tool was reviewed and endorsed at a PPM subgroup meeting in September 2006, which also included participants from TBCAP countries.