Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study
Objectives This study aimed to assess the practices of private practitioners regarding tuberculosis (TB), and to ascertain factors related to the low contribution of private healthcare providers to TB prevention and care in Nigeria.Design This is a mixed methods study comprising a quantitative retro...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/9/e069123.full |
| _version_ | 1797669416460091392 |
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| author | Adebola Lawanson Obioma Chijioke-Akaniro Simeon Onyemaechi Joseph Kuye Emperor Ubochioma Amos Omoniyi Ochuko Urhioke Victor O Ombeka Abiodun Hassan Sunday Asuke Chukwuma Anyaike Corinne S Merle |
| author_facet | Adebola Lawanson Obioma Chijioke-Akaniro Simeon Onyemaechi Joseph Kuye Emperor Ubochioma Amos Omoniyi Ochuko Urhioke Victor O Ombeka Abiodun Hassan Sunday Asuke Chukwuma Anyaike Corinne S Merle |
| author_sort | Adebola Lawanson |
| collection | DOAJ |
| description | Objectives This study aimed to assess the practices of private practitioners regarding tuberculosis (TB), and to ascertain factors related to the low contribution of private healthcare providers to TB prevention and care in Nigeria.Design This is a mixed methods study comprising a quantitative retrospective review and qualitative study.Setting Private health facilities (HF) in Oyo State and the Federal Capital Territory (FCT), Nigeria.Participants We used routinely collected data on patients with tuberculosis (TB) notified between 1 January 2017 and 31 December 2018. In-depth interviews were also conducted with the clinical staff of the facilities.Primary and secondary outcome measures The study outcomes are practices of TB case notification and treatment outcome, as well as the barriers and enablers of TB notification.Results A total of 13 (11.0%) out of 118 private HF were designated as ‘engaged’ TB care facilities in Oyo State and none (0%) of the 198 private HF in the FCT held this designation. From the 214 patients with presumptive TB, 75 (35%) were diagnosed with TB, 42 (56%) had a bacteriological test done, 12 (16%) had an X-ray of the chest alone and 21 (28%) had other non-specific investigations. Most patients diagnosed were referred to a public HF, while 19 (25%) patients were managed at the private HF. Among them, 2 (10.5%) patients were treated with unconventional regimens, 4 (21%) were cured, 2 (11%) died, 3 (16%) lost to follow-up and 10 (53%) were not evaluated. The general practitioners did not have up-to-date knowledge of TB with a majority not trained on TB. Most referred patients with presumptive and confirmed TB to the public sector without feedback and were unclear regarding diagnostic algorithm and relevant tests to confirm TB.Conclusion Most private facilities were not engaged to provide TB services although with knowledge and practice gaps. The study has been used to develop plans for strategic engagement of the private sector in Nigeria. |
| first_indexed | 2024-03-11T20:44:03Z |
| format | Article |
| id | doaj.art-096ae435410f4e488a3e8f469051ccfc |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T20:44:03Z |
| publishDate | 2023-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-096ae435410f4e488a3e8f469051ccfc2023-10-01T16:40:08ZengBMJ Publishing GroupBMJ Open2044-60552023-09-0113910.1136/bmjopen-2022-069123Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods studyAdebola Lawanson0Obioma Chijioke-Akaniro1Simeon Onyemaechi2Joseph Kuye3Emperor Ubochioma4Amos Omoniyi5Ochuko Urhioke6Victor O Ombeka7Abiodun Hassan8Sunday Asuke9Chukwuma Anyaike10Corinne S Merle11National Tuberculosis and Leprosy Control Programme, Abuja, NigeriaNational Tuberculosis and Leprosy Control Programme, Abuja, NigeriaAnambra State Health Insurance Agency, Awka, Anambra, NigeriaJohn Snow International, Abuja, NigeriaNational Tuberculosis and Leprosy Control Programme, Abuja, NigeriaPublic Health Physician Abuja, Abuja, NigeriaNational Tuberculosis and Leprosy Control Programme, Abuja, NigeriaNational Tuberculosis and Leprosy Control Programme, Abuja, NigeriaJohn Snow International (JSI), Abuja, NigeriaBingham University, Karu, Nasarawa, NigeriaNational Tuberculosis and Leprosy Control Programme, Abuja, NigeriaPublic Health Research professional, Geneva, SwitzerlandObjectives This study aimed to assess the practices of private practitioners regarding tuberculosis (TB), and to ascertain factors related to the low contribution of private healthcare providers to TB prevention and care in Nigeria.Design This is a mixed methods study comprising a quantitative retrospective review and qualitative study.Setting Private health facilities (HF) in Oyo State and the Federal Capital Territory (FCT), Nigeria.Participants We used routinely collected data on patients with tuberculosis (TB) notified between 1 January 2017 and 31 December 2018. In-depth interviews were also conducted with the clinical staff of the facilities.Primary and secondary outcome measures The study outcomes are practices of TB case notification and treatment outcome, as well as the barriers and enablers of TB notification.Results A total of 13 (11.0%) out of 118 private HF were designated as ‘engaged’ TB care facilities in Oyo State and none (0%) of the 198 private HF in the FCT held this designation. From the 214 patients with presumptive TB, 75 (35%) were diagnosed with TB, 42 (56%) had a bacteriological test done, 12 (16%) had an X-ray of the chest alone and 21 (28%) had other non-specific investigations. Most patients diagnosed were referred to a public HF, while 19 (25%) patients were managed at the private HF. Among them, 2 (10.5%) patients were treated with unconventional regimens, 4 (21%) were cured, 2 (11%) died, 3 (16%) lost to follow-up and 10 (53%) were not evaluated. The general practitioners did not have up-to-date knowledge of TB with a majority not trained on TB. Most referred patients with presumptive and confirmed TB to the public sector without feedback and were unclear regarding diagnostic algorithm and relevant tests to confirm TB.Conclusion Most private facilities were not engaged to provide TB services although with knowledge and practice gaps. The study has been used to develop plans for strategic engagement of the private sector in Nigeria.https://bmjopen.bmj.com/content/13/9/e069123.full |
| spellingShingle | Adebola Lawanson Obioma Chijioke-Akaniro Simeon Onyemaechi Joseph Kuye Emperor Ubochioma Amos Omoniyi Ochuko Urhioke Victor O Ombeka Abiodun Hassan Sunday Asuke Chukwuma Anyaike Corinne S Merle Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study BMJ Open |
| title | Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study |
| title_full | Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study |
| title_fullStr | Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study |
| title_full_unstemmed | Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study |
| title_short | Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study |
| title_sort | challenges in engaging the private sector for tuberculosis prevention and care in nigeria a mixed methods study |
| url | https://bmjopen.bmj.com/content/13/9/e069123.full |
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