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Percent Bacteriologically Confirmed in Private Sector

References in the content below refer to the PBMEF Guide.

Definitions

Percent of new and relapse pulmonary TB notifications in the private sector that are bacteriologically confirmed.

Bacteriologically confirmed: Smear positive for TB or culture positive for TB or positive for TB by a World Health Organization-recommended rapid diagnostics test (WRD): FluoroType® MTBDR (Hain), Loopamp™ MTBC detection kit (TB-LAMP), Xpert® MTB/RIF, Xpert® MTB/RIF Ultra, Truenat® MTB or MTB Plus, RealTime MTB (Abbott), BD MAX™ MDR-TB, cobas® MTB (Roche), or LF-LAM. 

Calculation: (Numerator/Denominator) x 100

Numerator

Number of new and relapse bacteriologically confirmed pulmonary TB notifications in the private sector (smear positive or culture positive or positive by (WRD) during the reporting period

Denominator

Number of new and relapse pulmonary TB notifications in the private sector (bacteriologically confirmed plus clinically diagnosed) during the reporting period
Ref #
PR_BAC_CON
Tier Level
Project Level Indicators
Category
Reach
Type
Outcome
Unit of Measure
Percent of people
Data Type
Percentage
Disaggregations
Age (0–4, 5–14, 15+)
Sex
Reporting Level
Project Level indicators are expected to be reported at the subnational level for subnational units where the partner is operating. National data may also be reported if available.
Reporting Frequency
This indicator should be reported on an annual basis at a minimum. More frequent monitoring on a quarterly or monthly basis is recommended.

The data sources for the private sector may vary country to country. Private sector facilities within the National TB Program (NTP) network should report their data to the NTP where it would be captured in the basic management unit TB register, laboratory register, and electronic management information systems at the health facility and district level.

Engaging with private sector healthcare providers is essential to achieve universal access to TB prevention and care services. Countries that have prioritized private sector engagement show increases in the contribution of the private sector to overall TB case notifications. Global and national goals in TB cannot be achieved unless private providers are engaged on a large scale.

This indicator measures the percent of people with new and relapse pulmonary TB who were notified by private non-NTP providers that are bacteriologically confirmed —which is the starting point for ensuring that people with TB identified by private providers will receive quality diagnosis and care.

Contributions from private facilities and care providers to the total number of TB notifications should be regularly monitored. Introducing and using simplified case reporting for the private sector through electronic reporting or app-based reporting are some of the interventions to encourage private sector reporting, but intermediary agencies who can engage with diverse private providers are typically also necessary.

The percent of people with privately notified pulmonary TB who are bacteriologically confirmed TB can be analyzed over time and/or between subregions. They can also be compared to the total number of TB notifications to determine the percent of all TB notifications that are coming from the private sector.

A further analysis of this indicator using granular data can also provide valuable insights into who these private providers are in terms of their geographic and institutional locations, as well as their share in private sector notifications. It may be possible that the majority of all private sector notifications come from just a few regular private sector institutions. Better understanding of these high and low performers may help to expand the private sector notification base. For countries with large contributions from private providers, a richer set of standard indicators could be used to distinguish contributions from (a) private for-profit vs. private not-for-profit; (b) providers at different levels of the healthcare system (pharmacies vs. primary care vs. secondary/tertiary care); and (c) private referrals vs. private case management. 

Limitations in data use include inconsistent reporting on private sector notifications from countries and non-disaggregated data on nonprofit and for-profit private providers.

Below are examples one can use when presenting this indicator:

  • Percent of public vs private sector bacteriologically confirmed TB case notifications (bar charts, or trend lines over time)
  • DS-TB cascade (disaggregated by public vs private)
There are no related indicators for this indicator.

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