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. 2022 Feb 17;22(1):215.
doi: 10.1186/s12913-022-07612-3.

Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study

Merita Arini  1   2 , Dianita Sugiyo  3   4 , Iman Permana  5   3
Affiliations

Challenges, opportunities, and potential roles of the private primary care providers in tuberculosis and diabetes mellitus collaborative care and control: a qualitative study

Merita Arini et al. BMC Health Serv Res. .

Abstract

Introduction: The comorbidity of tuberculosis and diabetes mellitus (TB-DM) is a looming global co-epidemic problem. Despite the Indonesian Government's ongoing effort to impose regulation for collaborative TB-DM management, the involvement of private primary care providers (PPCs) has not been considered before the COVID-19 pandemic. This study aimed to capture the PPCs' existing practices and explore their challenges, opportunities, and potential roles in the collaborative TB-DM services and control.

Methods: A descriptive qualitative research design was used to collect data. Two Focus Group Discussions (FGDs) were conducted with 13 healthcare workers (HCWs) from different private clinics and eight private/solo general practitioners (GPs) from Yogyakarta City, Indonesia. We triangulated these data with data from FGDs of HCWs community health centers (CHCs) and in-depth interviews of three regional health regulators, five hospitals staff members, and a representative of national health insurance. The discussions were audio-recorded, transcribed verbatim, and subjected to thematic analysis.

Results: PPCs have not been initiated into the implementation of the collaborative TB-DM programme. The themes identified in this study were health system-related barriers, knowledge and perception of HCWs, lack of implementation of bi-directional screening, and needs of multisector role. The potential roles identified for PPCs include involvement in health promotion, bi-directional screening, patient referral, and data reporting according to the TB-DM programme indicators. However, more thorough improvement of PPCs' capacity and logistic supplies are needed to provide comprehensive TB treatment.

Conclusion: Although PPCs' involvement in implementing collaborative TB-DM services has yet to be considered, their potential role should not be neglected. Therefore, it is essential to increase their involvement by enhancing their capacity and improving the Public-Private Mix. PPCs' engagement should be initiated and maintained to ensure the sustainability of the programme.

Keywords: Chronic disease; Diabetes mellitus; Private primary care; Public-private mix; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

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