A conceptual framework on determinants of the integrated tuberculosis control model implementation in China

Area of Science:

• Public Health
• Health Services Research
• Health Management

Background:

• Improving tuberculosis (TB) care is crucial for achieving global End TB Strategy goals.
• China's integrated TB control model, initiated in 2012, faces challenges in effective TB care delivery.
• A lack of a comprehensive framework hinders understanding of factors influencing TB care provision within this model.

Purpose of the Study:

• To propose a novel conceptual framework for understanding the determinants of TB care provision within China's integrated TB control model.
• To offer a multi-perspective understanding of TB care determinants, emphasizing a patient-centered approach.
• To guide empirical research and intervention development for improving TB control system-level barriers.

Main Methods:

• Developed a conceptual framework integrating public management and health services insights.
• Adapted the PRISM (Promoting Research in Social Sciences and Medicine) model and its elements.
• Incorporated health system blocks and implementation research outcome indicators.

Main Results:

• The proposed framework comprises 4 modules and 7 domains of determinants for integrated TB control implementation.
• Hypothesizes that TB control services are public services requiring a patient-centered approach.
• Evaluation encompasses both implementation and service outcomes.

Conclusions:

• The conceptual framework provides a structured approach to identify barriers and facilitators in integrated TB control.
• It can guide empirical investigations and the development of targeted interventions.
• The framework supports enhancing the quality and effectiveness of TB care within integrated health systems.