The impact of pandemic on TB services and the recovery plans in Indonesia and Nigeria
The COVID Effects on TB Services in the Private Sector (COVET) study set out to evaluate the impact of the COVID-19 pandemic on tuberculosis services in the private healthcare sectors of India, Indonesia, and Nigeria. The TBPPM Learning Network along with the COVET study team organized two webinars in the month of April. These webinars focused on the results from the COVET study in Nigeria, particularly surrounding changes in the availability of TB and COVID-19 services in the private sector, effects on care-seeking and pathways to care among people with TB, and the quality of TB care measured using standardized patient visits.
Nigeria
The project assessed the impact of COVID-19 on Nigeria's private healthcare sector through three studies. TB case notifications increased by 15% in 2020, with private facilities playing a vital role in TB care. During the lockdown, 70% of private providers remained open, though some services were disrupted. Patient experiences showed that 53.4% sought care within a week, while 11.1% delayed for over two months. Delays occurred in patient and provider stages, with Lagos having more patient delay and Kano experiencing provider delay.
The National TB Program implemented various measures, such as bidirectional screening, providing TB care through community organizations, and expanding services to private and public facilities. The National TB Program aimed to strengthen private sector engagement through a customized approach and improve domestic resource mobilization to support private sector financing.
Read the webinar report on the lessons learned from Nigeria
Indonesia
Indonesia ranks second globally for TB burden, with an estimated 1 million cases annually. Underreporting is a challenge due to insufficient notification by hospitals and private practitioners. The INSTEP-1 study found that 73% of TB patients initially sought help from private practitioners. Progress has been made in TB treatment coverage, MDR-TB case enrollment, and child TB case detection through collaborative efforts.
In response to the COVET study, various interventions were implemented. These included monitoring the number and contribution of private providers, expanding engagement with private primary care providers, increasing access to Molecular rapid diagnostic testing (MWRD) machines, identifying barriers to seeking treatment through the KAP study, engaging with pharmacies and labs, advocating for support for TB patients' essential costs, and implementing performance-based payment and revised guidelines.Overall, private practitioners have the potential to contribute significantly to TB care in Indonesia. Efforts are being made to address the challenges they face and improve collaboration between the public and private sectors to enhance TB control and treatment outcomes.
Read the webinar report on the lessons learned from Indonesia