Engaging Private Providers to Enhance Tuberculosis Detection and Notification: Evidence from TB REACH- Supported Projects
Engaging private providers to enhance tuberculosis detection and notification: evidence from TB REACH-Supported projects
This study evaluated 35 innovative private provider engagement (PPE) projects across 19 countries under the TB REACH initiative, with nearly USD 14 million invested. By integrating a diverse range of private health providers—including formal clinicians, pharmacies, informal practitioners, laboratories, and formal facilities—the projects effectively enhanced the TB notification cascade. Over 13 million individuals were screened, resulting in more than 64,000 TB notifications, with an impressive 97% linked to quality-assured treatment. This comprehensive approach contributed to a 25% increase in overall TB notifications in the intervention areas, with PPE activities accounting for about 20% of total notifications, demonstrating the transformative potential of targeted private sector engagement.
Detailed analyses revealed notable operational efficiencies. On average, 281 individuals needed to be screened and 7 tested to yield one TB notification. Mapping exercises identified nearly 70,000 private providers, of which more than 21,000 were actively engaged, and 58% of these providers referred individuals for diagnostic testing. Different provider types played complementary roles; for instance, private pharmacies and drug stores, which comprised 55% of engaged providers, delivered high notification volumes, while private formal facilities, though fewer in number, achieved remarkable referral yields per facility. This tailored and context-specific engagement strategy ensured that interventions were optimally aligned with local healthcare-seeking behaviors and regulatory environments.
The findings suggest that structured and targeted PPE enhances TB notifications and contributes to closing the gap of missing notifications. These results emphasize the need for wider implementation and scale-up of PPE strategies in the TB response. Geographic comparisons further underscored the importance of localized approaches—while most engaged providers were in Asia, regions such as Africa achieved higher average notifications per active provider. Overall, these positive findings highlight that structured, context-driven PPE initiatives not only boost TB notifications but also offer a scalable and cost-effective model for strengthening TB responses globally, paving the way for broader implementation and sustained impact.