We support global efforts to engage private sector healthcare workers in the provision of high-quality TB care.
Large portions of the population in developing countries seek care for tuberculosis (TB) symptoms in the private sector – this is particularly true in Asia. Too often, the care received in the private sector is of poor quality, worsening health outcomes and driving continued transmission of TB.
PSI has extensive expertise training throughout Asia and Africa. We support a wide variety of private sector care providers including general practitioners, pharmacists and traditional healers.
PSI has successfully used social franchising as an approach to TB care and control, to expand access to TB care in Myanmar, Pakistan, Vietnam, Laos and, most recently, Kenya. This approach includes:
- Training private sector providers to offer high-quality TB services as defined by national and international standards, including TB screening, diagnosis and treatment.
- Ongoing monitoring through regular supervision visits to ensure that quality is prioritized and maintained over time.
- Franchise clinics are branded to display their commitment to quality; we then promote this brand to create demand for high-quality services. This model is particularly effective at engaging small-scale providers that are often difficult to reach with other public private mix (PPM) models.
We also work to reach TB patients through other approaches. Research indicates that pharmacists and traditional healers are often the first providers to interact with people exhibiting symptoms of TB. In India, Myanmar and Laos, we train large networks of pharmacists to identify TB symptoms and link clients to diagnostic and treatment services. In India, more than 2,000 underqualified healthcare providers have been trained to identify TB symptoms and link their patients to quality care in the public sector.
Throughout these activities, we utilize provider behavior change communication techniques to influence clinical behaviors and practices. Using these techniques, we uncover individual provider needs, as well as and clients’ barriers to performing desired behavior, such as TB screening. Based on these findings, we develop and manage a tailored behavior change strategy for each provider. This results in a more targeted approach to achieving sustained provision of quality of TB services. These techniques can influence a range of TB-related provider behaviors – including increasing the number of clients screened for TB who are referred to diagnostic services; providing adherence counseling; and executing proper infection prevention practices in their health facility.