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WHO Guide to develop a national action plan on public-private mix (PPM) for Tuberculosis prevention and care

March 01, 2018

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The importance of engaging all providers in tuberculosis (TB) care and prevention has been recognized for well over a decade. Over 4 million people with TB are missed each year by health systems and therefore do not get the care they need and deserve. A large proportion of these patients, especially in Asia, are diagnosed and managed in the private sector or unengaged public sector, but not notified to national health systems. Multiple studies have shown extensive use of the private sector, with an average of 50% (in Sub-Saharan Africa) to 80% (in South Asia) of initial visits being in the private sector. Failure to engage with these providers can result in long delays in diagnosis and treatment, resulting in further TB transmission, and poor quality diagnosis and treatment, leading to the development of multidrug-resistant TB (MDR-TB).

Goal and objectives of this document
This document has one simple goal: to guide national programmes in developing an action plan for PPM that will close the gap in reaching the missed cases using PPM approaches. Such plans should, in turn, fulfill four objectives:
1. Provide an easy reference to keep track of need versus coverage in all the distinct elements of PPM (e.g., hospitals, GPs, pharmacies, etc), as outlined in the NSA guide.
2. Review the regulatory environment for PPM, while defining the implementation arrangements
3. Provide a clear roadmap for national level planning of PPM, reflecting more ambitious PPM plans with broad coverage and allocated resources.
4. Build high-level commitment at the national level to build or strengthen linkages with the private sector.

Target Audience
This document is targeted for use by national TB programmes, partners and consultants supporting countries in developing proposals or providing technical assistance in scaling up PPM approaches in the country

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