Contribution of the private health sector to all forms of TB case detection in Ethiopia: A five-year retrospective analysis

Background: With the support of USAID Private Health Sector Program, led by Abt Associates Inc., the Ethiopian Ministry of Health initiated Public-Private Mix-Directly Observed TB Treatment Short course (PPM-DOTS) service in 2006. At present, the program is implemented in 317 PPM-DOTS private facilities. Currently, 4,500 facilities (both public & private) provide TB DOTS in the country.

Methodology: A quantitative study was conducted using quarterly reported data from both public and private health facilities between August 2006 and July 2011. Simple descriptive and comparative statistical analyses were performed using EPI-Info 3.3.2.

Results: A total of 61,525 of all forms of TB patients were diagnosed in the private facilities in a period of five years. Of these, 14,283 were retained and treated in the facilities while the majority, 47,242 (76.7%), were referred to other, public facilities. The overall national figure for all forms of TB cases detected during the same period was 671,422, showing the private contribution to be 9.1% of all forms of TB detected nationally.

Conclusion: PPM-DOTS program in Ethiopia is contributing significantly to detection nationally of all forms of TB. It is also an effective and efficient way of improving case detection if scaled up, integrated and owned by the national TB program. High referral rate calls for establishing strong referral linkages between the public and private health facilities.