PSP Ethiopia: New Partnership for TB Control Links the Ministry of Health and Private Sector
Tuberculosis (TB) causes two million deaths worldwide every year. Ethiopia’s Federal Ministry of Health estimated in 2005 that nearly 415,000 Ethiopians were ill with active TB disease, but only 33 percent of those cases were detected and being treated by healthcare providers. TB is of particular concern because it is a contagious disease which spreads through the air. Each person with active TB who is not treated will infect an average of 10 to 15 other people every year.
On March 28, the Federal Ministry of Health announced a new partnership between the public and private healthcare sectors to improve access to TB treatment. The partnership, known as Public-Private Mix (PPM) in TB Care engages private sector health care providers in TB case detection, treatment, and reporting. The public sector provides free TB drugs, and is responsible for regulation and supervision.
Until recently, people with TB could obtain treatment only in public health facilities. The Ministry and private health care providers expect that as the PPM expands, it will give more Ethiopians easier access to TB care. Improved access to care is important because TB treatment requires daily visits to the healthcare provider during the first two months of care for monitoring.
In fourteen other countries that have launched more than 40 PPM projects, the results show that it is a feasible and cost effective way to improve both detection of new TB cases and treatment outcomes. Early results in Addis Ababa are encouraging. In the first three months of the pilot program, 11 facilities in Addis have identified and begun treatment of 440 patients with TB.
The Ministry’s announcement this week is the culmination of almost two years of work to establish a policy, develop detailed program guidelines, and begin pilot testing in 20 private facilities. In July 2005, the Ministry began a consultative process with the private sector as well as national and international organizations committed to TB control. Representatives of these groups worked together to develop detailed guidelines which define what is required from both the public and the private sector in order to establish the Public-Private Mix in TB Care.
The PPM in TB Care will increase the number of places where Ethiopians can receive quality TB care. This partnership will also help to build more synergy between the National TB & Leprosy Control Program and the country’s HIV/AIDS programs.
The USAID Private Sector Program (PSP) for TB/HIV supported the Ministry by convening dialogue workshops and consultative meetings, gathering experience with PPM programs from other countries, and helping formulate the guidelines for PPM. PSP also trained health care workers in 20 private facilities which are currently pilot testing the PPM model and guidelines. Through PSP, USAID also helps workplace clinics in some of Ethiopia’s largest public and private companies to improve TB case detection, diagnosis, and directly observed therapy short-course (DOTS) treatment. The project assists clinical TB and HIV programs in 56 large workplaces and fosters TB/HIV peer education programs in a total of 81 workplaces that serve over 400,000 beneficiaries.
