Private sector care-seeking pathways and delays in TB care in India, Indonesia and Nigeria in times of COVID-19
 
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1
University of Waterloo, Canada
 
2
McGill University, Canada
 
3
McGIll University, Canada
 
4
McGill International TB Centre, Canada
 
5
Department of Epidemiology and Biostatistics, Universitas Padjadjaran, Indonesia
 
 
Publication date: 2023-04-27
 
 
Popul. Med. 2023;5(Supplement):A250
 
ABSTRACT
India, Indonesia, and Nigeria have the 1st, 3rd, and 6th highest burden of TB globally. Combined, they accounted for 44% of new cases and 50% of deaths from TB globally in 2021. In these countries, a majority (71% on average) of initial TB care-seeking are with private providers, yet private providers accounted for only 15-31% of TB notifications. The WHO reported that there are 1.8M (or 43% of global total) people with TB that are were not diagnosed in these countries. Reports also show that COVID-19 pandemic has reversed years of progress in the TB response due to control measures and overwhelmed healthcare systems. Our study in these 3 countries show how care-seeking pathways for TB care has changed in 2021, and what implications these changes have for health system recovery post-pandemic. We used cross-sectional surveys with 529 patients in India (n=200), Indonesia (n=149) and Nigeria (n=180) to find onset of symptoms, care-seeking pathway, TB diagnosis and treatment initiation, healthcare use during COVID-19, and the impact of COVID-19 on their care. The results showed significant increases in care-seeking delays, and in numbers of encounters with public and private sector providers. Our study highlights the need to strengthen public-private partnerships, equip the private sector with more access to TB testing tools, implement effective bidirectional screenings for TB and COVID and increasee training for private providers on TB detection.
ISSN:2654-1459
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