Abstract
Objective To identify the challenges encountered by private health care providers (PHCP) to notify tuberculosis cases through a programme developed web-based portal mechanism called “NIKSHAY.” Study Design. It is a descriptive qualitative study conducted at two revised national tuberculosis control programme (RNTCP) districts of New Delhi. The study included in-depth interviews of PHCP registered with “NIKSHAY” and RNTCP programme personnel. Grounded theory was used to conceptualise the latent social patterns in implementation of tuberculosis case notification process and promptly identifying their challenges. Results The analysis resulted in identification of three broad themes: (a) system implementation by RNTCP: it emphasizes the TB notification process by the RNTCP programme personnel; (b) challenges faced by PHCP for TB notification with five different subthemes; and (c) perceived gaps and suggestions: to improvise the TB notification process for the private health sector. The challenges encountered by PHCP were mainly related to unsystematic planning and suboptimal implementation by programme personnel at the state and district level. The PHCP lacked clarity on the need for TB notification. Conclusion Implementation of TB notification among private health care providers requires systematic planning by the programme personnel. The process should be user-friendly with additional benefits to the patients.
Highlights
In India, tuberculosis continues to be the major public health problem
The complete process of how the activities were performed by revised national tuberculosis control programme (RNTCP) staff, flow of information, implementation of TB notification system and challenges faced by RNTCP and private health care providers (PHCP), gaps, and suggestions are discussed
A study based on literature search on notification system across high-incidence countries provided insights in private provider perceptions, including barriers to notification
Summary
In India, tuberculosis continues to be the major public health problem. It accounts for 27% (2.8 million) of the estimated global annual incidence of 10.4 million tuberculosis (TB) cases [1]. One-third of the nearly nine million people are estimated to fall ill with TB each year and many out of them could not be reached by TB programme. This “missing” patient, of population over three million, has stubbornly remained unchanged since 2007 [3]. The increase can be attributed to the increased TB notification which otherwise was not notified earlier to the programme
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