PROPER CARE in the Private Sector (PCPS)
July 2017 – September 2019
In Viet Nam, the number of people on TB treatment in the private sector is unknown and treatment effectiveness and outcomes are not monitored. In 2017, FIT launched the PROPER CARE in the Private Sector (PCPS) project in Districts 07, 10 and Go Vap of Ho Chi Minh City, Viet Nam to better understand and address these knowledge gaps. Modelled after the successful Public-Private Interface Agency (PPIA) initiatives in India, PCPS was designed as a provider-friendly approach to improve diagnosis, treatment and follow-up for patients accessing TB care outside of the current National TB Program (NTP) system. PCPS sought to create a sustainable environment for effective TB control in the private sector and to generate evidence for national-level policy change.
For PCPS’s first strategy, we built a diagnostic referral network to improve TB diagnosis in the private sector and linkage of patients with treatment at public facilities. PCPS is the first of its kind to provide Xpert MTB/RIF testing to private-sector clients in Ho Chi Minh City. Since the launch of PCPS, we have trained over 200 private clinicians and pharmacists about new diagnostic tests, standardized TB medicines and treatment follow up schedules in line with NTP guidelines. Each private clinician was given an X-ray referral voucher booklet so they can distribute vouchers to people who have signs and symptoms of TB. These individuals can go to either their closest District TB Unit (DTU) for a free chest X-ray (CXR) or a private radiography center partnered with PCPS for a free/reduced-rate CXR. If a person’s CXR image suggests that they may have TB, they are asked to provide a sputum sample for testing with the Xpert MTB/RIF assay, a new diagnostic test that can detect TB bacteria in 2 hours. If the test is positive for TB, they are then counselled about the benefits of receiving free, quality-assured TB treatment at a DTU.
PCPS’s second strategy has focused on documenting private-sector TB treatment practices outside the diagnostic referral initiative. Results from this strategy highlights the potential scale of private treatment in urban Viet Nam and the importance of these people being formally recognized in the NTP notification data.
PCPS was implemented from June 2017 to March 2019 with funding from TB REACH Wave 5.
In 2019, following engagement and discussion with members of the NTP, FIT was given access to expand the piloting of these services and prospectively notify private sector treatment practices in the national TB electronic notification system (VITIMES). This is a significant achievement, and we hope to pilot the scale up of this approach under a TB REACH Wave 7 grant.