Evidence map›Paper›PMID 39837582›Full record

ArticleBMJ global health2025

Health and tuberculosis systems resilience, the role of the private sector and pandemic preparedness: insights from a cross-country qualitative study with policy-makers in India, Indonesia and Nigeria.

Laura Jane Brubacher, Vijayashree Yellappa, Bony Wiem Lestari, Petra Heitkamp, Nathaly Aguilera Vasquez, Angelina Sassi, Bolanle Olusola-Faleye, Poshan Thapa, Joel Shyam Klinton, Surbhi Sheokand and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. COVID-19 policies and tuberculosis services in private health sectors of India, Indonesia, and Nigeria.Journal of clinical tuberculosis and other mycobacterial diseases · 2025
    Article
  3. Article
  4. Article
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.

Laura Jane BrubacherSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada ljbrubacher@uwaterloo.ca.ORCID http://orcid.org/0000-0003-2806-9539
Vijayashree YellappaTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.ORCID http://orcid.org/0000-0003-0390-7874
Bony Wiem LestariResearch Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia.ORCID http://orcid.org/0000-0002-6476-2034
Petra HeitkampTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.ORCID http://orcid.org/0000-0002-5530-2271
Nathaly Aguilera VasquezTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.
Angelina SassiTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.ORCID http://orcid.org/0000-0002-5807-6388
Bolanle Olusola-FaleyeSustaining Health Outcomes through the Private Sector (SHOPS) Plus/Abt Associates, Lagos, Nigeria.
Poshan ThapaTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.
Joel Shyam KlintonTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.
Surbhi SheokandTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.ORCID http://orcid.org/0009-0008-0749-8063
Madhukar PaiTB PPM Learning Network, McGill International TB Centre, McGill University, Montreal, Québec, Canada.ORCID http://orcid.org/0000-0003-3667-4536
Charity Oga-OmenkaSchool of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.ORCID http://orcid.org/0000-0003-0779-570X

Funding

Gates Foundation INV-022420
6 · The paper itself

Abstract

introductionThe COVID-19 pandemic was an unprecedented challenge to health systems worldwide and had a severe impact on tuberculosis (TB) case notifications and service delivery. India, Indonesia and Nigeria are high TB-burden countries where the majority of initial care-seeking happens in the private health sector. The objectives of this study were to (1) explore policy-makers' perspectives on the impact of the COVID-19 pandemic on private sector TB service delivery in India, Indonesia and Nigeria and (2) identify cross-cutting insights for pandemic preparedness with respect to TB service delivery.

methodsFrom May to November 2021, 33 interviews were conducted with key policy-makers involved in health service administration, TB service delivery and/or the COVID-19 response in India, Indonesia and Nigeria (n=11 in each country). Interviews focused on the impact of COVID-19 on TB services and lessons learnt for pandemic preparedness with respect to TB in each study context. Data were analysed thematically using a hybrid inductive-deductive approach, informed by Haldane

resultsPolicy-makers highlighted the crucial role of intersectoral collaboration, effective governance, innovative financing strategies, health workforce reallocation and technological advancements such as virtual consultations and mHealth in strengthening TB service delivery amid the COVID-19 pandemic. India relied on patient-provider support agencies to implement a joint strategy for TB care across sectors and states. Indonesia engaged networks of private provider professional associations to facilitate coordination of the COVID-19 response. Nigeria implemented a pandemic policy for public-private referral for the continuity of TB care.

conclusionsCountries implemented varied measures to support TB service delivery during the COVID-19 pandemic. This study presents insights from three countries (India, Indonesia and Nigeria) that together offer a 'menu' of possibilities for supporting pandemic preparedness with respect to TB care vis-à-vis strengthening health systems resilience.

Indexed as

Administrative PersonnelCOVID-19Delivery of Health CarePrivate SectorTuberculosisHealth PolicyHumansIndiaIndonesiaNigeriaPandemic PreparednessPandemicsQualitative ResearchSARS-CoV-2Global HealthHealth services researchHealth systemsQualitative studyTuberculosis

Identifiers

PMID39837582
PMCPMC11751827

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.