International Journal of Health Policy and Management

International Journal of Health Policy and Management

Private Practitioners’ Perspectives on Their Involvement With the Tuberculosis Control Programme in a Southern Indian State

Document Type : Original Article

Authors
Solomon Salve 1, 2
Kabir Sheikh 3
John DH Porter 4
1 Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
2 The Maharashtra Association of Anthropological Sciences, Centre for Health Research and Development (MAAS-CHRD), Savitribai Phule Pune University, Pune, India
3 Public Health Foundation of India, New Delhi, India
4 Departments of Clinical Research and Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
10.15171/ijhpm.2016.52
Abstract
Background
Public and private health sectors both play a crucial role in the health systems of low- and middleincome countries (LMICs). The tuberculosis (TB) control strategy in India encourages the public sector to actively partner with private practitioners (PPs) to improve the quality of front line service delivery. However, ensuring effective and sustainable involvement of PPs constitutes a major challenge. This paper reports the findings from an empirical study focusing on the perspectives and experiences of PPs towards their involvement in TB control programme in India.
 
Methods
The study was carried out between November 2010 and December 2011 in a district of a Southern Indian State and utilised qualitative methodologies, combining observations and in-depth interviews with 21 PPs from different medical systems. The collected data was coded and analysed using thematic analysis.
 
Results
PPs perceived themselves to be crucial healthcare providers, with different roles within the public-private mix (PPM) TB policy. Despite this, PPs felt neglected and undervalued in the actual process of implementation of the PPM-TB policy. The entire process was considered to be government driven and their professional skills and knowledge of different medical systems remained unrecognised at the policy level, and weakened their relationship and bond with the policy and with the programme. PPs had contrasting perceptions about the different components of the TB programme that demonstrated the public sector’s dominance in the overall implementation of the DOTS strategy. Although PPs felt responsible for their TB patients, they found it difficult to perceive themselves as ‘partners with the TB programme.’
 
Conclusion
Public-private partnerships (PPPs) are increasingly utilized as a public health strategy to strengthen health systems. These policies will fail if the concerns of the PPs are neglected. To ensure their long-term involvement in the programme the abilities of PPs and the important perspectives from other Indian medical systems need to be recognised and supported.

Highlights

 

 

Watch the Video Summary here. 

 

Keywords
Public Sector
Private Sector
Private Practitioners (PPs)
Public-Private Mix (PPM)
Tuberculosis
(TB)
India
Subjects

 

 

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International Journal of Health Policy and Management
Volume 5, Issue 11
2016
Pages 631-642

  • Received Date 10 November 2015
  • Revised Date 09 March 2016
  • Accepted Date 01 May 2016
  • First Published Date 01 November 2016
  • Published Date 01 November 2016