Tuberculosis (TB)

Guidance for implementation of public-private mix for management of drug-resistant TB (PPM DR-TB)

Engaging all relevant health care providers in the management of DR-TB cases is an important intervention to achieve the goal of universal access to DR−TB care and services. However, only limited progress has been made to date in engaging non-NTP providers in the management of DR-TB patients. WHO/GTB conducted four in-country assessments to Myanmar, Nigeria, Pakistan and Turkey from November 2013 to February 2014. Following the in-country assessments, an "Expert consultation meeting on public-private mix for the management of drug-resistant tuberculosis (PPM DR-TB)", was held in Geneva, Switzerland, 23–24 June 2014. As a result of the assessments and consultation, the "Framework for engagement of all health care providers in the management of drug-resistant tuberculosis" has been developed.

The objectives of the Framework are:

  • to describe the rationale of, the approaches to, and the best practices in engagement of different health providers and partners in the management of drug-resistant TB patients; and
  • to describe the necessary components in planning and implementation of PPM DR-TB activities.

This document will help to guide National TB Programmes and partners in the adaptation and implementation of PPM DR-TB approaches in the many varied country settings.

A national situational assessment is very important for the planning and the implementation of PPM DR-TB activities in the respective country. A careful country-specific analysis about the current status of management of DR-TB patients, with a focus on all the various health care providers, will show the way forward towards achieving the goal of universal access to quality diagnosis and treatment for all cases of tuberculosis, including those with DR−TB. A country assessment tool has been designed and field tested in 4 countries.

This tool enables a country or other users to gather the needed data that will serve as a basis for designing a sound plan of expanding DR-TB management, by engaging all relevant care providers. The objective of the assessment tool is to assist countries in moving towards engagement of all relevant health care providers in DR-TB management. The main objective of this tool is to facilitate a comprehensive assessment of a country’s current situation in terms of PPM TB and drug-resistant TB care.

This document shares best practices in engagement of health care providers in programmatic management of drug-resistant tuberculosis that have been documented in different countries and regions and implemented by different stakeholders. Case studies presented in the document are lessons learned for scale-up of public-private mix for the management of drug-resistant TB at country level.

National TB programmes, technical agencies and other partners can submit case studies of public-private mix for drug-resistant TB (PPM DR-TB) for posting on this website. Sharing your best practices and experiences helps others to learn about your successful stories and help scale up the implementation of PPM DR-TB globally.

Submit your case studies on PPM DR-TB

Please send to nguyenli@who.int.