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Collaboration between private pharmacies and national tuberculosis programme: an intervention in Bolivia
M L Lambert1, R Delgado, G Michaux
1Epidemiology and Diseases Control Unit, Department of Public Health, Institute for Tropical Medicine, Antwerp, Belgium. mllambert@itg.be
Tropical Medicine & International Health : TM & IH
|February 26, 2005
Summary
Public-private partnerships reduced tuberculosis (TB) drug availability in Bolivian pharmacies and improved referrals to the National TB Programme (NTP). However, pharmacy referrals did not significantly increase TB screening rates or shorten diagnosis delays.
Area of Science:
- Public Health
- Infectious Disease Control
- Health Systems Research
Background:
- Public-private partnerships are crucial for tuberculosis (TB) control in developing nations.
- Bolivia faces the highest TB incidence in Latin America, necessitating innovative control strategies.
Purpose of the Study:
- To assess the feasibility and impact of a collaboration between Bolivia's National TB Programme (NTP) and private pharmacies.
- To evaluate the effectiveness of interventions aimed at reducing TB drug availability and improving patient referral in private pharmacies.
Main Methods:
- A two-phase intervention was implemented in Cochabamba, Bolivia, involving collaboration with the Pharmacists' Association.
- Phase 1 focused on voluntary reduction of TB drug sales and enhanced referral of clients seeking TB drugs.
- Phase 2 aimed to increase referral of individuals with chronic cough for TB screening, evaluated via referral slips.
Main Results:
- The proportion of pharmacies selling key TB drugs (rifampicin, isoniazid) significantly decreased (P<0.001).
- Pharmacies referring clients seeking TB drugs to the NTP increased substantially (22% to 58%, P<0.0001).
- Phase 2 saw 38% of pharmacies referring clients; 27% were screened, and 27% of those screened were diagnosed with smear-positive TB.
Conclusions:
- The intervention effectively reduced TB drug availability in pharmacies and improved initial client referrals.
- Collaboration between private pharmacies and public health services is feasible for specific TB control measures.
- Pharmacy collaboration appears inefficient for increasing TB screening numbers and reducing diagnostic delays.
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