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ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 5  |  Page : 713-721

Extent of involvement of private practitioners in public-private mix-directly observed treatment short course (PPM-DOTS) for tuberculosis management in South Coastal India: A mixed-method study


1 Department of Community Medicine, Indira Gandhi Medical College and Research Institute(IGMCRI), Puducherry, India
2 Department of Biochemistry, School of Studies in Biochemistry, Jiwaji University, Gwalior, Madhya Pradesh, India
3 Department of Community Medicine, IPGMER & SSKM Hospital, Kolkata, India

Correspondence Address:
Mausumi Basu
Department of Community Medicine, IPGME and R and SSKM Hospital, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_7_21

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Background: Ensuring the effective participation of both public and private healthcare providers is essential to fulfill the goals of universal access to tuberculosis (TB) care. Objectives: The objective was to assess the knowledge, attitude, and practice about TB, Directly Observed Treatment Short (DOTS) program and Public-Private Mix-DOTS course (PPM-DOTS) strategy among allopathic private practitioners (PP) and to explore their extent of involvement in PPM-DOTS strategy in the diagnosis, notification, and management of TB in Puducherry, India. Materials and Methods: A sequential explanatory mixed-method study was conducted from November 2017 to February 2018 with quantitative survey using a pretested semistructured questionnaire followed by in-depth interview (IDI) using field guide. Descriptive manual content analysis was performed after verbatim transcription of the manuscripts from IDIs. Results: Qualitative data based on survey revealed that 97.66% of PPs were aware of subjecting patients with cough for more than 2 weeks for sputum examination and 93.75% were aware of mandatory TB notification. About 88.28% preferred to get the investigation done for presumptive TB cases from nearby DOTS centers. About 89.06% preferred to refer TB cases to nearby primary health centers whereas only 20.31% preferred to notify TB cases. IDIs revealed that PPM-DOTS was not utilized optimally due to the following reasons: minimal TB caseload to collaborate and function with DOTS centers, fear of losing the patient, distrust in PP, busy schedule, availability of Anti-tubercular treatment (ATT) in the nearby pharmacy, breach of confidentiality while notification and finally the easy referral mechanism due to nearby DOTS centers. Conclusions: Involvement of PPs in PPM-DOTS remains sub-optimal. Strategies such as conducting regular workshops, providing timely information about policy changes, and constructive communications individually with PPs to dispel any misconceptions might enhance PPM-DOTS.


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