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Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India

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Listed:
  • Ambarish Dutta
  • Sarthak Pattanaik
  • Rajendra Choudhury
  • Pritish Nanda
  • Suvanand Sahu
  • Rajendra Panigrahi
  • Bijaya K Padhi
  • Krushna Chandra Sahoo
  • P R Mishra
  • Pinaki Panigrahi
  • Daisy Lekharu
  • Robert H Stevens

Abstract

Background: Migrant labourers living in the slums of urban and industrial patches across India make up a key sub-population so far controlling Tuberculosis (TB) in the country is concerned. This is because many TB patients from these communities- remain under reached by the Revised National Tuberculosis Control Programme (RNTCP) of India. This marginalized community usually seeks early-stage healthcare from “friendly neighbourhood” non-formal health providers (NFHPs). Because, RNTCP has limited capacity to involve the NFHPs, an implementation research project was conceived, whereby an external partner would engage with the NFHPs to enable them to identify early TB symptomatics from this key sub-population who would be then tested using Xpert MTB/RIF technology. Diagnosed TB cases among them would be referred promptly to RNTCP for treatment. This paper aimed to describe the project and its impact. Methods: Adopting a quasi-experimental before-after design, four RNTCP units from two major urban-industrial areas of Odisha were selected for intervention, which spanned five quarters and covered 151,400 people, of which 30% were slum-dwelling migrants. Two similar units comprised the control population. The hypothesis was, reaching the under reached in the intervention area through NFHPs would increase TB notification from these traditionally under-notifying units. Results: The project detected 488 Xpert+ TB cases, of whom 466 were administered RNTCP treatment. This translated into notification of additional 198 new bacteriologically positive cases to RNTCP, a 30% notification surge, after adjustment for 2% decline in control. This meant an average quarterly increase in notification of 41.20(20.08, 62.31; p

Suggested Citation

  • Ambarish Dutta & Sarthak Pattanaik & Rajendra Choudhury & Pritish Nanda & Suvanand Sahu & Rajendra Panigrahi & Bijaya K Padhi & Krushna Chandra Sahoo & P R Mishra & Pinaki Panigrahi & Daisy Lekharu & , 2018. "Impact of involvement of non-formal health providers on TB case notification among migrant slum-dwelling populations in Odisha, India," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-16, May.
    • Handle: RePEc:plo:pone00:0196067
    DOI: 10.1371/journal.pone.0196067
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    References listed on IDEAS

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    1. May Sudhinaraset & Matthew Ingram & Heather Kinlaw Lofthouse & Dominic Montagu, 2013. "What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-12, February.
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    3. Huanxue Zhou & Christopher Taber & Steve Arcona & Yunfeng Li, 2016. "Difference-in-Differences Method in Comparative Effectiveness Research: Utility with Unbalanced Groups," Applied Health Economics and Health Policy, Springer, vol. 14(4), pages 419-429, August.
    4. William A Wells & Mukund Uplekar & Madhukar Pai, 2015. "Achieving Systemic and Scalable Private Sector Engagement in Tuberculosis Care and Prevention in Asia," PLOS Medicine, Public Library of Science, vol. 12(6), pages 1-10, June.
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