Can Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation...

Area of Science:

• Public Health
• Health Services Research
• Infectious Disease Management

Background:

• Navigating India's complex health system poses significant challenges for individuals with tuberculosis (TB) symptoms.
• Patient and family burden, compounded by gender discrimination and opportunity costs, often hinders completion of the diagnostic and treatment pathway.
• Patient navigators offer a potential solution to improve care cascade completion.

Purpose of the Study:

• To evaluate the impact of patient navigators on tuberculosis diagnosis and treatment completion in India.
• To assess the effectiveness of navigators in both public and private healthcare sectors.

Main Methods:

• Implementation of two navigator projects: one in Bihar's public sector and another in Andhra Pradesh's private sector.
• Accredited Social Health Activists (ASHAs) in Bihar and field officers in Andhra Pradesh facilitated patient navigation through diagnosis and treatment.
• Case-based data collection and analysis of TB notifications compared to baseline to determine intervention effect.

Main Results:

• Bihar: 94% increase in public TB notifications and 97% treatment initiation rate.
• Andhra Pradesh: 147% increase in private TB notifications with 100% treatment initiation.
• Navigator interventions demonstrated a substantial improvement in TB care cascade completion.

Conclusions:

• Patient navigators are effective in supporting patients through TB diagnostic and treatment pathways.
• This approach significantly improves the patient's health system experience and reduces loss to follow-up.
• Involving navigators in TB programs is a novel strategy to enhance care cascade completion and reduce attrition.