%0 Journal Article
%T Operational priorities for engaging with India's private healthcare sector for the control of tuberculosis: a modelling study.
%A Ricks S
%A Singh A
%A Sodhi R
%A Pal A
%A Arinaminpathy N
%J BMJ Open
%V 14
%N 3
%D 2024 Mar 19
%M 38508628
%F 3.006
%R 10.1136/bmjopen-2022-069304
%X <B>OBJECTIVE: </B>To estimate the potential impact of expanding services offered by the Joint Effort for Elimination of Tuberculosis (JEET), the largest private sector engagement initiative for tuberculosis (TB) in India.<BR><B>METHODS: </B>We developed a mathematical model of TB transmission dynamics, coupled with a cost model.<BR><B>METHODS: </B>Ahmedabad and New Delhi, two cities with contrasting levels of JEET coverage.<BR><B>METHODS: </B>Estimated patients with TB in Ahmedabad and New Delhi.<BR><B>METHODS: </B>We investigated the epidemiological impact of expanding three different public-private support agency (PPSA) services: provider recruitment, uptake of cartridge-based nucleic acid amplification tests and uptake of adherence support mechanisms (specifically government supplied fixed-dose combination drugs), all compared with a continuation of current TB services.<BR><B>RESULTS: </B>Our results suggest that in Delhi, increasing the use of adherence support mechanisms among private providers should be prioritised, having the lowest incremental cost-per-case-averted between 2020 and 2035 of US$170 000 (US$110 000-US$310 000). Likewise in Ahmedabad, increasing provider recruitment should be prioritised, having the lowest incremental cost-per-case averted of US$18 000 (US$12 000-US$29 000).<BR><B>CONCLUSIONS: </B>Results illustrate how intervention priorities may vary in different settings across India, depending on local conditions, and the existing degree of uptake of PPSA services. Modelling can be a useful tool for identifying these priorities for any given setting.