Implementing WHO DOTS strategy in the Russian Federation: stakeholder attitudes

Atun, Rifat; Baeza, Juan; Drobniewski, Francis; Levicheva, Vera; Coker, Richard

doi:10.1016/j.healthpol.2004.12.012

Cited by 18 publications

(10 citation statements)

References 33 publications

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“…Although DOTS was agreed to in principle, in practice PPs held a negative attitude towards the policy. Similar responses from private stakeholders have been documented by Atun et al 68 in their study on DOTS implementation in Russia.The idea of referring those suspected of having TB to government health facilities, has challenged the traditional medical role of PPs, giving them less freedom to diagnose or to decide on appropriate referrals. …”

Section: Discussionsupporting

confidence: 83%

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

Salve¹,

Sheikh²,

Porter³

2016

Int J Health Policy Manag

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Background: Public and private health sectors both play a crucial role in the health systems of low- and middle-income 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.

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Section: Discussionsupporting

confidence: 83%

“…Similar experiences of PPs feeling undervalued and demotivated in the TB programme have been reported in other studies conducted in India and elsewhere. 68,78 …”

Section: Discussionmentioning

confidence: 99%

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

Salve¹,

Sheikh²,

Porter³

2016

Int J Health Policy Manag

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“…Analysis focused on generat-FIGURE A model for the analysis of policy transfer. 7 Reprinted with permission of the International Union Against Tuberculosis and Lung Disease.…”

Section: Public Health Action Tb Diagnostic Implementation: Qualitatimentioning

confidence: 99%

“…5 In the Russian Federation, doctors and nurses are often perceived to be resistant to changing their ways of working. [7][8][9] Furthermore, a lack of coordination between public health services and sectors in the Russian Federation has been identified as a particular challenge. [10][11][12] The incomplete uptake of LPA by health service professionals would prevent patients from benefiting from this new technology.…”

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confidence: 99%

Health service perceptions about implementation of a new TB diagnostic in Northern Russia: a qualitative study

Кузнецов

Bissell

2016

public health action

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“…Sixth: the prevailing experiences and attitudes of stakeholders (both staff and patients) may lead to strong resistance to change; this may be based on the view that inpatient care is necessary to ensure good outcomes and because patients expect to be hospitalized. 28 In the short term, these constraints mean that significant improvements in the efficiency of TB-control programmes that are based on optimal use of beds are unrealistic. However, in the medium term it should be feasible to positively influence stakeholders' attitudes, revise existing approaches of resource allocation, introduce more efficient providerpayment systems, implement phased reductions in the number of hospital beds and staff, change existing regulations governing the management of patients with TB, and strengthen outpatient care and social-support services.…”

Section: Researchmentioning

confidence: 99%

Health systems efficiency in the Russian Federation: tuberculosis control

Floyd

Hutubessy

Samyshkin

et al. 2004

Bull World Health Organ

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Much of the Russian Federation's large tuberculosis hospital infrastructure is unnecessary when clinical and public health criteria are used, but the large hospital infrastructure within the tuberculosis-control system has an important social support function. Improving the efficiency of the system will require the reform of health-system norms and regulations as they relate to resource allocation and clinical care and implementation of lower-cost approaches to case management for patients with social problems. Additionally, closer attention will need to be paid to the management of staff numbers in the tuberculosis system.

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Implementing WHO DOTS strategy in the Russian Federation: stakeholder attitudes

Cited by 18 publications

References 33 publications

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

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

Health service perceptions about implementation of a new TB diagnostic in Northern Russia: a qualitative study

Health systems efficiency in the Russian Federation: tuberculosis control

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