Involvement of private practitioners in tuberculosis control in Ballabgarh, Northern India

The Revised National Tuberculosis Control Programme (RNTCP) in India covered 70% of the population in 2003. However, the private sector, where a large proportion of tuberculosis (TB) patients are seen, does not have sufficient involvement in the programme.

To test the feasibility of involving private practitioners (PPs) in the RNTCP for identification and management of TB cases.

PPs in Ballabgarh Block, Haryana, were identified and invited for training in RNTCP guidelines. They referred TB suspects for confirmation of diagnosis to a nearby public facility. Patients could subsequently choose to return to their referring doctor or to the government facility. Patients and doctors were interviewed at the end of the project to assess their perceptions.

Of 146 PPs, 72% were trained in RNTCP guidelines and 14 agreed to provide directly observed treatment (DOT). During the study period (May 2001-December 2003) 113 patients initiated treatment, leading to an incremental gain of 11.5% in case finding. The cure rate among the 113 sputum positive patients was 73%, and the default rate was 11.5%.

Involvement of private practitioners in TB control is possible and results in benefits for all stakeholders.