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. 2021 Jul;26(7):730-742.
doi: 10.1111/tmi.13574. Epub 2021 May 4.

TB notification rates across parliamentary constituencies in India: a step towards data-driven political engagement

Geeta Pardeshi  1   2 , Weiyu Wang  3 , Julie Kim  3 , Jeffrey Blossom  4 , Rockli Kim  5   6 , S V Subramanian  3   7   8
Affiliations

TB notification rates across parliamentary constituencies in India: a step towards data-driven political engagement

Geeta Pardeshi et al. Trop Med Int Health. 2021 Jul.

Abstract

Objective: National averages obscure geographic variation in program performance. We determined Parliamentary Constituency (PC)-wise estimates of TB notification to guide political engagement.

Methods: We extracted district-level TB notification data from the 2018 annual TB report. We derived PC-level estimates by building a 'cross-walk' between districts and PCs using boundary shapefiles. We described the spatial distribution of the PC-wise estimates of Total Notification Rate and percentage of Private Sector Notification.

Results: The median PC-wise Total Notification Rate was 126.24/100 000 (IQR: 94.86/100 000, 162.22/100 000). The median PC-wise Percentage Private Sector Notification was 18.03% (IQR: 9.56%, 26.84%). Only 16 (2.94%) PCs met the target of 50% private sector notification. Most of high notification rates in PCs were driven by high notification in public sector. There was geographic - both interstate and within state inter-PC - variation in the estimates of these indicators. The study identified some geographic patterns of notification - high positive outlier PCs with adjoining PCs in lower deciles of notification rates, intra-state differences in PC performance, and similarities in notification rates of adjoining PCs in different states.

Conclusion: In addition to regional inequality, the study identified geospatial patterns that can aid in the formulation of suitable interventions. These include decongestion of overburdened facilities by strengthening poorly performing units. The PCs with a high percentage Private Sector Notification can act as role models for neighbouring PCs to improve private sector engagement. MPs can play a crucial role in mobilising additional resources, creating awareness, and establishing inter-PC and inter-state collaboration to improve TB program performance.

Keywords: Geographic Information System (GIS) mapping; TB elimination; political commitment; regional variation.

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Figures

Figure 1
Figure 1
Process of cross‐walk to calculate PC level TB notification rate.
Figure 2
Figure 2
Distribution of (a) PC‐wise Total Notification Rates (per 100 000) (b) Percentage of private sector notification (%).
Figure 3
Figure 3
Distribution of (a) PC‐wise Notification Rates in Public Sector (per 100 000) (b) PC‐wise Notification Rates in Private Sector (per 100 000)
Figure 4
Figure 4
Boxplot of PC‐wise Total TB Notification rate per 100 000.
Figure 5
Figure 5
Geographic distribution of deciles of PC‐wise Total TB Notification rate per 100 000.
Figure 6
Figure 6
Geographic distribution of deciles of PC‐wise percentage of patients notified by private sector (%) in India.
Figure 7
Figure 7
Boxplot of PC‐wise Percentage Private Sector TB Notification (%).
Figure 8
Figure 8
Correlation between PC‐wise notification rates in the public and private sector.
See this image and copyright information in PMC

References

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