Evidence map›Paper›PMID 37709312›Full record

ArticleBMJ open2023

Challenges in engaging the private sector for tuberculosis prevention and care in Nigeria: a mixed methods study.

Obioma Chijioke-Akaniro, Simeon Onyemaechi, Joseph Kuye, Emperor Ubochioma, Amos Omoniyi, Ochuko Urhioke, Adebola Lawanson, Victor O Ombeka, Abiodun Hassan, Sunday Asuke and 2 more

Abstract read
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Obioma Chijioke-AkaniroNational Tuberculosis and Leprosy Control Programme, Abuja, Nigeria ocakaniro@gmail.com.ORCID 0000-0001-7906-0521
Simeon OnyemaechiAnambra State Health Insurance Agency, Awka, Anambra, Nigeria.
Joseph KuyeJohn Snow International, Abuja, Nigeria.
Emperor UbochiomaNational Tuberculosis and Leprosy Control Programme, Abuja, Nigeria.
Amos OmoniyiPublic Health Physician Abuja, Abuja, Nigeria.
Ochuko UrhiokeNational Tuberculosis and Leprosy Control Programme, Abuja, Nigeria.
Adebola LawansonNational Tuberculosis and Leprosy Control Programme, Abuja, Nigeria.
Victor O OmbekaNational Tuberculosis and Leprosy Control Programme, Abuja, Nigeria.
Abiodun HassanJohn Snow International (JSI), Abuja, Nigeria.
Sunday AsukeBingham University, Karu, Nasarawa, Nigeria.
Chukwuma AnyaikeNational Tuberculosis and Leprosy Control Programme, Abuja, Nigeria.
Corinne S MerlePublic Health Research professional, Geneva, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to assess the practices of private practitioners regarding tuberculosis (TB), and to ascertain factors related to the low contribution of private healthcare providers to TB prevention and care in Nigeria.

designThis is a mixed methods study comprising a quantitative retrospective review and qualitative study.

settingPrivate health facilities (HF) in Oyo State and the Federal Capital Territory (FCT), Nigeria.

participantsWe used routinely collected data on patients with tuberculosis (TB) notified between 1 January 2017 and 31 December 2018. In-depth interviews were also conducted with the clinical staff of the facilities. PRIMARY AND SECONDARY OUTCOME MEASURES: The study outcomes are practices of TB case notification and treatment outcome, as well as the barriers and enablers of TB notification.

resultsA total of 13 (11.0%) out of 118 private HF were designated as 'engaged' TB care facilities in Oyo State and none (0%) of the 198 private HF in the FCT held this designation. From the 214 patients with presumptive TB, 75 (35%) were diagnosed with TB, 42 (56%) had a bacteriological test done, 12 (16%) had an X-ray of the chest alone and 21 (28%) had other non-specific investigations. Most patients diagnosed were referred to a public HF, while 19 (25%) patients were managed at the private HF. Among them, 2 (10.5%) patients were treated with unconventional regimens, 4 (21%) were cured, 2 (11%) died, 3 (16%) lost to follow-up and 10 (53%) were not evaluated. The general practitioners did not have up-to-date knowledge of TB with a majority not trained on TB. Most referred patients with presumptive and confirmed TB to the public sector without feedback and were unclear regarding diagnostic algorithm and relevant tests to confirm TB.

conclusionMost private facilities were not engaged to provide TB services although with knowledge and practice gaps. The study has been used to develop plans for strategic engagement of the private sector in Nigeria.

Indexed as

General PractitionersTuberculosisAntibiotic ProphylaxisHumansNigeriaPrivate SectorOrganisation of health servicesPublic healthTuberculosis

Identifiers

PMID37709312
PMCPMC11148675

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