Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India

Dutta, Ambarish; Pattanaik, Sarthak; Choudhury, Rajendra; Nanda, Pritish; Sahu, Suvanand; Panigrahi, Rajendra; Padhi, Bijaya Kumar; Sahoo, Krushna Chandra; Mishra, Pravas Ranjan; Panigrahi, Pinaki; Lekharu, Daisy; Stevens, Robert

doi:10.1371/journal.pone.0196067

Cited by 19 publications

(32 citation statements)

References 30 publications

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“…Of these, more than half of the studies (62) were conducted at city level. The communicable diseases most frequently studied in the context of slums were diarrheal diseases (e.g., [54,55]), HIV (e.g., [56,57]), and tuberculosis (e.g., [58,59]), as expected. The communicable diseases are followed by studies on sexual and maternal behavior (13.6%).…”

Section: Analysis By Health Categoriessupporting

confidence: 70%

Slums, Space, and State of Health—A Link between Settlement Morphology and Health Data

Friesen

Dietrich

et al. 2020

IJERPH

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Approximately 1 billion slum dwellers worldwide are exposed to increased health risks due to their spatial environment. Recent studies have therefore called for the spatial environment to be introduced as a separate dimension in medical studies. Hence, this study investigates how and on which spatial scale relationships between the settlement morphology and the health status of the inhabitants can be identified. To this end, we summarize the current literature on the identification of slums from a geographical perspective and review the current literature on slums and health of the last five years (376 studies) focusing on the considered scales in the studies. We show that the majority of medical studies are restricted to certain geographical regions. It is desirable that the number of studies be adapted to the number of the respective population. On the basis of these studies, we develop a framework to investigate the relationship between space and health. Finally, we apply our methodology to investigate the relationship between the prevalence of slums and different health metrics using data of the global burden of diseases for different prefectures in Brazil on a subnational level.

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Section: Analysis By Health Categoriessupporting

confidence: 70%

Slums, Space, and State of Health—A Link between Settlement Morphology and Health Data

Friesen

Dietrich

et al. 2020

IJERPH

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“…Third, engagement of informal providers resulted in the identification of large numbers of PPTB, roughly constituting 7-8% of the TB patients detected in these TB Units [19]. The yield in the absolute number of PPTBs and TB cases was higher than a similar project conducted in Odisha State of India [20]. In the absence of this project, the 8342 PPTBs identified under this project either would have not been subjected to TB diagnostic evaluation or would have been subjected to diagnostic evaluation at a later stage.…”

Section: Discussionmentioning

confidence: 99%

“…This would have resulted in missed diagnosis or delayed diagnosis [ 21 ]. This would have increased the morbidity, mortality among these individuals, and the transmission of TB in the community, which was perhaps mitigated by the implementation of this project [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Engaging Informal Private Health Care Providers for TB Case Detection: Experiences from RIPEND Project in India

Kelamane¹,

Satyanarayana²,

Nagaraja

et al. 2021

Tuberculosis Research and Treatment

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Background. Informal (unqualified) health care providers are an important source of medical care for persons with presumptive TB (PPTB) in India. A project (titled RIPEND) was implemented to engage informal providers for the identification of PPTBs and TB patients in 4 districts of Telangana State, India, during October 2018-December 2019 project period. Engagement involved sensitizing the informal providers about TB, providing them financial incentives to identify PPTBs, and linking these PPTBs to diagnostic and treatment services provided by the Government of India’s National TB Elimination Programme. Objectives. To describe (a) the characteristics of the informal providers, along with their self-reported practices on TB diagnosis, treatment, and challenges encountered by the RIPEND project staff in engaging them in the project and (b) the outputs and outcomes of this engagement. Methods. We used a combination of one-on-one interviews with informal providers, group interviews with RIPEND project staff, and secondary analysis of data available within the project’s recording and reporting systems. Results. A total of 555 informal providers were actively engaged under the project. The majority (87%) had a nonmedicine-related graduate degree and had been providing medical care for more than 10 years. Most (95%) were aware that a cough for 2 weeks or more is a symptom of pulmonary TB and that such patients should be referred for sputum-smear microscopy at a government health facility. Challenges in engaging the informal providers included motivating them to participate in the study, suboptimal mobile usage for referral services, and delays in providing financial incentives to them for referring PPTBs. During the project period (October 2018-December 2019), 8342 PPTBs were identified of which 1003 TB patients were detected and linked to TB treatment services. Conclusion. This project showed that engaging informal providers is feasible and that a large number of PPTB and TB patients can be identified through this effort. The Government of India should consider engaging informal providers for the early diagnosis of TB to reduce the missing TB cases in the country.

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“…The most commonly featured IPs in TB care were Traditional Health Practitioners (THPs) (n = 8) [ 30 – 32 , 49 , 51 , 53 , 55 , 58 ], followed by traditional birth attendants (TBAs) (n = 3) [ 50 , 56 , 57 ] and drug sellers, storekeepers, and chemists (n = 3) [ 30 , 31 , 52 ]. The least featured IP type were untrained allopathic practitioners (n = 2) [ 30 , 54 ]. In all studies, IPs were given some training in TB before their involvement, but the duration varied.…”

Section: Resultsmentioning

confidence: 99%

“…A substantial body of research suggests that they are the first point of contact for a significant proportion of TB patients [ 27 , 28 ], but beyond that point, our understanding of their role in the prevention, diagnosis, and treatment of TB is limited. Studies which have explored the role of IPs in tuberculosis care have found that they create community awareness, assist in the diagnosis of symptomatic cases, and conduct sputum collection [ 30 – 32 ]. However, to our knowledge, their role has not been systematically explored using an evidence synthesis approach.…”

Section: Introductionmentioning

confidence: 99%

Role of informal healthcare providers in tuberculosis care in low- and middle-income countries: A systematic scoping review

et al. 2021

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Achieving targets set in the End TB Strategy is still a distant goal for many Low- and Middle-Income Countries (LMICs). The importance of strengthening public-private partnership by engaging all identified providers in Tuberculosis (TB) care has long been advocated in global TB policies and strategies. However, Informal Healthcare Providers (IPs) are not yet prioritised and engaged in National Tuberculosis Programs (NTPs) globally. There exists a substantial body of evidence that confirms an important contribution of IPs in TB care. A systematic understanding of their role is necessary to ascertain their potential in improving TB care in LMICs. The purpose of this review is to scope the role of IPs in TB care. The scoping review was guided by a framework developed by the Joanna Briggs Institute. An electronic search of literature was conducted in MEDLINE, EMBASE, SCOPUS, Global Health, CINAHL, and Web of Science. Of a total 5234 records identified and retrieved, 92 full-text articles were screened, of which 13 were included in the final review. An increasing trend was observed in publication over time, with most published between 2010–2019. In 60% of the articles, NTPs were mentioned as a collaborator in the study. For detection and diagnosis, IPs were primarily involved in identifying and referring patients. Administering DOT (Directly Observed Treatment) to the patient was the major task assigned to IPs for treatment and support. There is a paucity of evidence on prevention, as only one study involved IPs to perform this role. Traditional health providers were the most commonly featured, but there was not much variation in the role by provider type. All studies reported a positive role of IPs in improving TB care outcomes. This review demonstrates that IPs can be successfully engaged in various roles in TB care with appropriate support and training. Their contribution can support countries to achieve their national and global targets if prioritized in National TB Programs.

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Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India

Cited by 19 publications

References 30 publications

Slums, Space, and State of Health—A Link between Settlement Morphology and Health Data

Slums, Space, and State of Health—A Link between Settlement Morphology and Health Data

Engaging Informal Private Health Care Providers for TB Case Detection: Experiences from RIPEND Project in India

Role of informal healthcare providers in tuberculosis care in low- and middle-income countries: A systematic scoping review

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