scholarly journals Public–Private Mix Models of Tuberculosis Care in Pakistan: A High-Burden Country Perspective

2021 ◽  
Vol 9 ◽  
Author(s):  
Waseem Ullah ◽  
Ahmad Wali ◽  
Mahboob Ul Haq ◽  
Aashifa Yaqoob ◽  
Razia Fatima ◽  
...  
Keyword(s):  
Healthcare System ◽  
Treatment Success ◽  
Control Program ◽  
National Database ◽  
Governmental Organization ◽  
Tb Control ◽  
Control Programs ◽  
National Implementation ◽  
Public Private Mix ◽  
Case Notification

Introduction: Pakistan ranks fifth in the globally estimated burden of tuberculosis (TB) case incidence. Annually, a gap of 241,688 patients with TB exists between estimated TB incidence and actual TB case notification in Pakistan. These undetected/missed TB cases initiate TB care from providers in the private healthcare system who are less motivated to notify patients to the national database that leads to significant underdetection of actual TB cases in the Pakistani community. To engage these private providers in reaching out to missing TB cases, a national implementation trial of the Public–Private Mix (PPM) model was cohesively launched by National TB Control Program (NTP) Pakistan in 2014. The study aims to assess the implementation, contribution, and relative treatment outcomes of cohesively implemented PPM model in comparison to the non-PPM model.Methods: A retrospective record review of all forms (new and relapse) patients with TB notified from July 2015 to June 2016 was conducted both for PPM- and non-PPM models.Results: The PPM model was implemented in 92 districts in total through four different approaches and contributed 25% (81,016 TB cases) to the national TB case notification. The PPM and non-PPM case notification showed a strong statistical difference in proportions among compared variables related to gender (p < 0.001), age group (p < 0.000), and province (p < 0.000). Among PPM approaches, general practitioners and non-governmental-organization facilities achieve a treatment success of 94–95%; private hospitals achieve 82% success, whereas Parastatals are unable to follow more than half of their notified TB cases.Discussion: The PPM model findings in Pakistan are considerably consistent with countries that have prioritized PPM for an increasing trend in the TB case notification to their national TB control programs. Different PPM approaches need to be scaled up in terms of PPM implemented districts, PPM coverage, PPM coverage efficiency, and PPM coverage outcome in the Pakistani healthcare system in the future.

scholarly journals PHARMACISTS' PERCEPTION ABOUT THEIR ROLES IN TUBERCULOSIS CONTROL PROGRAM IN MEDAN, INDONESIA

2017 ◽  
Vol 10 (4) ◽  
pp. 256
Author(s):  
Khairunnisa B ◽  
Azizah Nasution
Keyword(s):  
Control Program ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Tb Control ◽  
Control Programs ◽  
Validated Questionnaire ◽  
Directly Observed Treatment ◽  
Tb Control Program

Objectives: to assess the pharmacists' perception about their roles in tuberculosis (TB) control program in Medan, Indonesia. Methods: A cross-sectional study was conducted to assess the pharmacists' perception about their roles in TB control program in Medan, Indonesia using a validated questionnaire. The pharmacists involved in this study (n=117) were asked to choose answering yes, no or do not know for their perception on their roles in TB control program. The collected data consisted of demographics (gender, age, place of practice, and working experience) and the pharmacists’ perception on their roles in TB control program were organized and analyzed by applying descriptive and Chi-square analyses using Statistical Package for the Social Sciences (SPSS, version 19, Chicago, IL, USA) (p value <0.05 was considered significant). Results: Mean age of the participants was 38.6 (standard deviation=11.7) years. Most of them (76.1%) were female. Distribution of the participants by place of practice:  pharmacy, 78.6%; hospital, 20.5%. Most of them (63.2%) have heard about directly observed treatment short-course (DOTS) program. More than 90% of them realized that they could play their roles as providers, managers of anti-TB drugs, drug informans, ensurers for adherence to the TB treatment, educators for patients and publics on TB and its treatment. Only 26.5% of them knew that they could also play their role as inventors of early suspected TB in the community.Conclusion: The study proved that the pharmacists’ roles could be utilized and enhanced to optimize TB control programs in Indonesia.Keywords: Pharmacists’ role, Tuberculosis, DOTS Program

scholarly journals Public-Private Mix Implementation and Achievements of Tuberculosis Control Program at Puskesmas in Pekanbaru

2021 ◽  
Vol 21 (2) ◽  
pp. 86-94
Author(s):  
Elda Nazriati ◽  
Zulharman Zulharman ◽  
Fifia Chandra ◽  
Ucha Anggiani Putri
Keyword(s):  
Success Rate ◽  
Local Governments ◽  
Secondary Data ◽  
Control Program ◽  
Tuberculosis Control ◽  
Notification Rate ◽  
Tuberculosis Control Program ◽  
Increasing Trend ◽  
Public Private Mix ◽  
Case Notification

Public-Private Mix (PPM) is a strategy implemented in countries with a high burden of tuberculosis, including Indonesia. This study aims to identify PPM implementation at the Puskesmas and the success of the TB control program at the Puskesmas that have implemented the PPM strategy. The research was conducted in 2019 in Pekanbaru Municipality. It was an observational study that collected quantitative and qualitative data. The implementation of PPM was assessed through guided interviews. The success of the Tuberculosis control program was assessed through the Case Notification Rate and Success Rate using secondary data from 2010 to 2017. The results showed that PPM had been implemented in six health centers in Pekanbaru. However, there were obstacles such as a lack of human resources, NGOs, private clinics, and local governments. The Case Notification Rate and Success Rate showed an increasing trend after the PPM implementation. However, these indicators had not yet reached the national target. It can be concluded that PPM in Pekanbaru had been implemented but needed to be improved at all Puskesmas by involving more partnerships and following up on obstacles encountered. Furthermore, the Tuberculosis Control Indicator had shown an increasing trend, but it needed to reach the national target.

scholarly journals A study on the incidence of tuberculosis in Narail district of Bangladesh

Mediscope ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 12-15
Author(s):  
MS Mallick
Keyword(s):  
Control Program ◽  
Situational Analysis ◽  
Pulmonary Tb ◽  
Tb Control ◽  
Related Data ◽  
Number Of Patients ◽  
Case Rate ◽  
Extra Pulmonary ◽  
The Government ◽  
Tb Control Program

The aim of this descriptive type of study on diagnosed tuberculosis (TB) cases was to evaluate the incidence of TB in Narail district to have a situational analysis with the achievement of National TB Control Program. Related data were collected from the Civil Surgeon Office, Narail district. The data of 3 upazilas- Narail Sadar, Kalia, and Lohagora were used. The study period was from January 1, 2016 to December 31, 2016. The overall TB case rate was 156.6 per 100000 population and separately 170.9 per 100000 population in Narail Sadar, 142.2 per 100000 population in Kalia and 156.6 per 100000 population in Lohagora. Of the cases, 56.4% were male and 43.6% female. Overall, 89.7% of the TB cases had pulmonary TB and 10.3% had extra-pulmonary TB. The population with higher age had higher proportion having TB. The highest number of patients were referred for diagnosis by sastha sebika (nurse) and non-government field staff. The TB incidence in Narail district was considered to be lower than the National situation. However, it seems that TB will remain as a continuous concern for many years in future for the country as well as Narail district. The activities of National TB Control Program of the Government of Bangladesh needs to be strengthened further to combat TB in BangladeshMediscope Vol. 5, No. 2: Jul 2018, Page 12-15

Synthesis of the process of training of technological commands and auxiliary operations of cyclic electro-automatics when programming multipurpose equipment in the complex of operating systems CNC and PLC

2021 ◽  
pp. 40-44
Author(s):  
YU.N. Kurnasov E.V. Bugrov ◽  
E.V. Kurnasov
Keyword(s):  
Operating Systems ◽  
Control Program ◽  
Control Device ◽  
Numerical Control ◽  
Technological Equipment ◽  
Cnc Machine ◽  
Graphical Programming ◽  
Control Programs ◽  
G Code ◽  
The Subject

A method for preparing technological conditions for programming and elements for implementing control programs of multipurpose technological equipment in the complex of operating systems of the CNC and PLC are proposed. The subject solution effectively combines the elements of parametric and graphical programming in the development of both CNC and PLC subprograms. Keywords: control program, algorithmic programming, G-code, numerical control device, programmable logic controller, electroautomatics, technological equipment, CNC machine. [email protected]

Cost-Consequence Analysis of Single-Dose Dalbavancin Versus Standard of Care for the Treatment of Acute Bacterial Skin and Skin Structure Infections in a Multisite Healthcare System

2020 ◽  
Author(s):  
Julia Gonzalez ◽  
Diana Carolina Andrade ◽  
JianLi Niu
Keyword(s):  
Healthcare System ◽  
Treatment Success ◽  
Standard Of Care ◽  
Cost Of Care ◽  
Secondary Outcome ◽  
Total Cost ◽  
Skin Structure ◽  
Cost Consequence ◽  
The Difference ◽  
The Cost

Abstract Background Acute bacterial skin and skin structure infections (ABSSSIs) are common infectious diseases that cause a significant economic burden on the healthcare system. This study aimed to compare the cost-effectiveness of dalbavancin vs standard of care (SoC) in the treatment of ABSSSI in a community-based healthcare system. Methods This was a retrospective study of adult patients with ABSSSI treated with dalbavancin or SoC during a 27-month period. Patients were matched based on age and body mass index. The primary outcome was average net cost of care to the healthcare system per patient, calculated as the difference between reimbursement payments and the total cost to provide care to the patient. The secondary outcome was proportion of cases successfully treated, defined as no ABSSSI-related readmission within 30 days after the initiation of treatment. Results Of the 418 matched patients, 209 received SoC and 209 received dalbavancin. The average total cost of care per patient was greater with dalbavancin vs SoC ($4770 vs $2709, P &lt; .0001). The average reimbursement per patient was $3084 with dalbavancin vs $2633 SoC (P = .527). The net cost, calculated as revenue minus total cost, was $1685 with dalbavancin vs $75 with SoC (P = .013). The overall treatment success rate was 74% with dalbavancin vs 85% with SoC (P = .004). Conclusions Dalbavancin was more costly than SoC for the treatment of ABSSSI, with a higher 30-day readmission rate. Dalbavancin does not offer an economic or efficacy advantage.

scholarly journals Evaluation the Pulmonary Tuberculosis Control Program with Strategy DOTS in Puskesmas Tanah Kalikedinding Surabaya

2014 ◽  
Vol 2 (2) ◽  
pp. 251
Author(s):  
Adistha Eka Noveyani ◽  
Santi Martini
Keyword(s):  
Pulmonary Tuberculosis ◽  
Health Center ◽  
Control Program ◽  
Tuberculosis Patient ◽  
Tuberculosis Control ◽  
Control Programs ◽  
Department Of Health ◽  
Inhibiting Factor ◽  
Rate Evaluation ◽  
Almost All

ABSTRACTStrategy DOTS is the tuberculosis control programs. The program has implemented in Tanah Kalikedinding Health Center and has expected to reach CDR ≥ 70% and SR ≥ 85%, which closely related to the management of health centers. This study aimed to evaluate the implementation of the DOTS program in health center whose the results associated with indicators of tuberculosis. This was a descriptive design study with the population was all pulmonary specialist, tuberculosis officers and laboratory personnel and pulmonary tuberculosis patients. The number of Tuberculosis patient respondents was 32 respondents. Samples were chosen using purposive sampling. Data collected by interview questionnaire and checklist. The variables were the finding case, the TB treatment, the enabling factor and inhibiting factor, recording and reporting, and result of tuberculosis indicators. This study resulted that CDR in 2013 was 112% already reached the national target ≥ 70%. This success related to the finding case almost all patients > 2 weeks of cought and all (100%) patients were examinated sputum and diagnosed according to the steps of tuberculosis diagnosis in Indonesia Department of Health guidelines. While SR in 2013 was 65.5% did not reach the target ≥ 85%. It was caused of there are patients who did not have a taking drug observer (PMO). All (100%) patients ever forgot taking anti tuberculosis drugs. Change in schedule of visit to the continuation phase be 2×/month caused patients to forget taking anti tuberculosis drugs. The enabling factor was counseling routinely by health care workers in health center. Inhibiting factor was distance to health center by majority (65,5%) patients were > 1 km. So they needed vehicle to go to the health center. Recording and reporting using electronic systems and being reported by online. So it is expected all TB patients were expected have a taking drug observer and optimizing the role of the a taking drug observer to increase success rate.Keywords: DOTS strategy, Case Detection Rate, Success Rate, evaluation,                     Tuberculosis

scholarly journals Evaluating the impact of the nationwide public–private mix (PPM) program for tuberculosis under National Health Insurance in South Korea: A difference in differences analysis

PLoS Medicine ◽  
2021 ◽  
Vol 18 (7) ◽  
pp. e1003717
Author(s):  
Sarah Yu ◽  
Hojoon Sohn ◽  
Hae-Young Kim ◽  
Hyunwoo Kim ◽  
Kyung-Hyun Oh ◽  
...  
Keyword(s):  
South Korea ◽  
Private Sector ◽  
Treatment Outcomes ◽  
Difference In Differences ◽  
Public And Private ◽  
The Public ◽  
Tb Control ◽  
Tb Treatment ◽  
Private And Public ◽  
Public Private Mix

Background Public–private mix (PPM) programs on tuberculosis (TB) have a critical role in engaging and integrating the private sector into the national TB control efforts in order to meet the End TB Strategy targets. South Korea’s PPM program can provide important insights on the long-term impact and policy gaps in the development and expansion of PPM as a nationwide program. Methods and findings Healthcare is privatized in South Korea, and a majority (80.3% in 2009) of TB patients sought care in the private sector. Since 2009, South Korea has rapidly expanded its PPM program coverage under the National Health Insurance (NHI) scheme as a formal national program with dedicated PPM nurses managing TB patients in both the private and public sectors. Using the difference in differences (DID) analytic framework, we compared relative changes in TB treatment outcomes—treatment success (TS) and loss to follow-up (LTFU)—in the private and public sector between the 2009 and 2014 TB patient cohorts. Propensity score matching (PSM) using the kernel method was done to adjust for imbalances in the covariates between the 2 population cohorts. The 2009 cohort included 6,195 (63.0% male, 37.0% female; mean age: 42.1) and 27,396 (56.1% male, 43.9% female; mean age: 45.7) TB patients in the public and private sectors, respectively. The 2014 cohort included 2,803 (63.2% male, 36.8% female; mean age: 50.1) and 29,988 (56.5% male, 43.5% female; mean age: 54.7) patients. In both the private and public sectors, the proportion of patients with transfer history decreased (public: 23.8% to 21.7% and private: 20.8% to 17.6%), and bacteriological confirmed disease increased (public: 48.9% to 62.3% and private: 48.8% to 58.1%) in 2014 compared to 2009. After expanding nationwide PPM, absolute TS rates improved by 9.10% (87.5% to 93.4%) and by 13.6% (from 70.3% to 83.9%) in the public and private sectors. Relative to the public, the private saw 4.1% (95% confidence interval [CI] 2.9% to 5.3%, p-value < 0.001) and −8.7% (95% CI −9.7% to −7.7%, p-value <0.001) higher rates of improvement in TS and reduction in LTFU. Treatment outcomes did not improve in patients who experienced at least 1 transfer during their TB treatment. Study limitations include non-longitudinal nature of our original dataset, inability to assess the regional disparities, and verify PPM program’s impact on TB mortality. Conclusions We found that the nationwide scale-up of the PPM program was associated with improvements in TB treatment outcomes in the private sector in South Korea. Centralized financial governance and regulatory mechanisms were integral in facilitating the integration of highly diverse South Korean private sector into the national TB control program and scaling up of the PPM intervention nationwide. However, TB care gaps continued to exist for patients who transferred at least once during their treatment. These programmatic gaps may be improved through reducing administrative hurdles and making programmatic amendments that can help facilitate management TB patients between institutions and healthcare sectors, as well as across administrative regions.

scholarly journals Spatiotemporal dynamics of tuberculosis in East Hararge Zone, Oromiya Region, Ethiopia

2020 ◽  
Vol 28 (6) ◽  
pp. 623-633
Author(s):  
Aboma Temesgen Sebu ◽  
Kasahun Takele Genati ◽  
Daniel Biftu Bekalo ◽  
Teshome Kebede Deressa
Keyword(s):  
Control Program ◽  
Health Concern ◽  
Global Public Health ◽  
Notification Rate ◽  
Relative Risks ◽  
National Tuberculosis Control Program ◽  
National Tuberculosis ◽  
Spatio Temporal ◽  
Tuberculosis Disease ◽  
Case Notification

Abstract Tuberculosis disease burden remains a fundamental global public health concern for decades. The disease may not uniformly distributed with certain geographical areas recording higher notification rate than others. However, the Ethiopian national TB control program does not provide services based on those areas with the greatest notifications but rather on a uniform strategy. Therefore, this study aimed to assess the spatial distribution and presence of the spatio-temporal clustering of the disease in different geographic settings over 8 years in the East Hararge Zone. A retrospective space-time and spatial analysis were carried out at districts of East Hararghe zone based on a total of 34,564 notified TB cases during the study period. The study identified different case notification rate over districts and clustering effects for the purely spatial and spatiotemporal with different estimated relative risks. The study recommends national tuberculosis control program to give attention to highly observed case notification rates specially Babile, Haramaya and Jarso districs of East Hararge Zone to have effective TB intervention in the study area.

scholarly journals Optimization of control program for CNC machines with regarding dynamic stability of cutting process and optimum modes of treatment in conditions of digital production

2018 ◽  
Vol 226 ◽  
pp. 04016
Author(s):  
Yuri G. Kabaldin ◽  
Dmitrii A. Shatagin ◽  
Pavel V. Kolchin
Keyword(s):  
Neural Network ◽  
Artificial Intelligence ◽  
Neural Networks ◽  
Dynamic Stability ◽  
Control Program ◽  
Cutting Process ◽  
Cnc Machines ◽  
Control Programs ◽  
Digital Production ◽  
Optimizing Control

The method for optimizing control programs for CNC machines based on artificial intelligence approaches, in particular, the apparatus of artificial neural networks, is outlined. A neural network model of the dynamic stability of the cutting process is proposed, which makes it possible to simulate the dynamics of the cutting process using the CAM system.

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