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Truth is relative; Client report versus provider report, a post-modern analysis of data from a trial in the private retail medicine sector.

In malaria-endemic countries, private retail outlets are a major source of antimalarials for individuals experiencing an acute febrile illness. However, there remains a challenge in how the decision to dispense the drugs is made. The lack of malaria diagnostic tools in the retail sector leads to a presumptive approach to diagnosis and overuse of ACTs. The TESTsmART study trained retail outlet attendants to perform malaria rapid diagnostic tests (mRDTs) in conjunction with a mobile application to capture testing and drug dispensing data. Concurrently, febrile clients were randomly selected for

Impact of a private sector residential early parenting program on clinically significant postnatal depressive symptoms experienced by women: Audit of routinely collected data.

INTRODUCTION: Early parenting services in Australia offer brief structured residential programs to address moderate to severe non-psychotic mental health problems among women and unsettled infant/toddler behaviours. The aims were to (1) estimate the immediate and medium-term impact of a five-night psychoeducational residential early parenting program on postpartum depressive symptoms and (2) identify the factors associated with improvement or worsening of postpartum depressive symptoms after completing the program and six weeks post-discharge. METHODS: Audit of routinely collected medical rec

Diagnose-Specific Antibiotic Prescribing Patterns at Otorhinolaryngology Inpatient Departments of Two Private Sector Healthcare Facilities in Central India: A Five-Year Observational Study.

Antibiotics are over-prescribed in low-and-middle-income countries, where the infection rate is high. The global paucity of standard treatment guidelines and reliable diagnose-specific prescription data from high-infection risk departments such as the otorhinolaryngology (ENT: ears, nose and throat) is a barrier to rationalize antibiotic use and combat antibiotic resistance. The study was conducted to present diagnose-specific antibiotic prescribing patterns of five years at ENT inpatient departments of two private-sector Indian hospitals. Data of all consecutive inpatients (n = 3527) were col

Antibiotic prescribing among patients with severe infectious diseases in two private sector hospitals in Central India - a time series analysis over 10 years.

BACKGROUND: Antibiotic resistance is an emerging problem caused due to antibiotic use. In countries with high rates of infectious diseases, antibiotic resistance is a frequent cause of mortality. The aim was to analyse antibiotic prescribing practices between 2008 and 2017 in a teaching (TH) and a non-teaching (NTH) hospital, as typical hospitals of low- and middle-income countries, and to compare antibiotic prescribing for severe infectious indications for which empiric antibiotic treatment is recommended. METHODS: Data from adult patients registered at two Indian private-sector hospitals wi

Adherence of healthcare providers to malaria case management guidelines of the formal private sector in north-western Ethiopia: an implication for malaria control and elimination.

BACKGROUND: Malaria is an infectious disease which has been globally targeted for elimination in at least 35 of 90 endemic countries by 2030. Most successful malaria elimination country programmes have engaged the private health sector in an effort to identify, document, investigate, provide effective treatment, and follow-up cases. However, there has been limited rigorous research showing evidence of adherence among healthcare providers of the formal private health sector to national malaria diagnosis and treatment guidelines in Ethiopia, starting from malaria control to elimination phases. T

Uptake, satisfaction, and quality of family planning services in Pakistan: before and during Covid-19 outbreak: Stocktaking with clients of a private sector organisation.

OBJECTIVE: To report the uptake, satisfaction, and quality of family planning services in the clients of a private sector organisation during Covid-19 in Pakistan and compare it with the situation before Covid-19 pandemic. METHODS: This paper is based on the client exit interview data collected before and then after the outbreak of Covid-19, using a structured questionnaire. Clients were chosen at the exit of the social franchise (SF) clinics, situated in rural and peri-urban areas, and beneficiaries of the outreach services delivery channel in the remote rural area. Descriptive analysis was …

Comparative analysis of COVID-19 vaccine and booster acceptance among healthcare workers in public and private sectors in KwaZulu-Natal, South Africa.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic posed unprecedented global health challenges, necessitating accelerated COVID-19 vaccine development. However, vaccine and booster hesitancy among healthcare workers (HCWs) presented a barrier globally and in South Africa (SA). AIM: This study aimed to determine the level of vaccine and booster acceptance among HCWs in public, private and public-private sectors in KwaZulu-Natal (KZN), SA, and to identify the key reasons of vaccine and booster acceptance and refusal. SETTING: This study was conducted across KZN. METHODS: A quantita…

Tuberculosis Prevention in the Private Sector: Using Claims-Based Methods to Identify and Evaluate Latent Tuberculosis Infection Treatment With Isoniazid Among the Commercially Insured.

CONTEXT: Targeted identification and treatment of people with latent tuberculosis infection (LTBI) are key components of the US tuberculosis elimination strategy. Because of recent policy changes, some LTBI treatment may shift from public health departments to the private sector. OBJECTIVES: To (1) develop methodology to estimate initiation and completion of treatment with isoniazid for LTBI using claims data, and (2) estimate treatment completion rates for isoniazid regimens from commercial insurance claims. METHODS: Medical and pharmacy claims data representing insurance-paid services rend…

A time-to-treatment initiation analysis for treatment-naive early-stage resectable non-small cell lung cancer patients in the Malaysian private healthcare sector.

INTRODUCTION: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer mortality in Malaysia, with 95% of cases diagnosed at advanced stages. Beyond screening for early detection, timely intervention is critical for optimal outcomes in early-stage, resectable NSCLC (e-NSCLC). Delays in the diagnostic, staging and referral pathway, measured as time-to-treatment initiation (TTI), are associated with poorer survival. This contemporary realworld study is the first to evaluate TTI in a cohort of Malaysian patients with e-NSCLC. MATERIALS AND METHODS: This is a retrospective study of 12

Private sector engagement for immunisation programmes: a pragmatic scoping review of 25 years of evidence on good practice in low-income and middle-income countries.

INTRODUCTION: Many National Immunisation Programmes attempt to leverage the private sector ; however, there is limited consolidated and synthesised documentation on good practices, gaps and lessons learnt. A 2017 WHO guidance document recommended best practices for private sector engagement (PSE) in immunisation. We conducted a pragmatic scoping review to identify gaps, update and consolidate evidence on promising practices in PSE for vaccination. METHODS: Building on two previous reviews published in 2011 and 2017, we conducted a pragmatic scoping review of peer-reviewed publications from lo…

Does labour epidural slow the progress of labour and lead to complications? Obstetricians' perception working in private and public sector teaching hospitals in a developing country.

BACKGROUND AND AIMS: Obstetricians play a major role in the decision making for provision of analgesia for the woman in labour. As epidural … if they would recommend EA to their patients. When these responses were compared between public and private sector, a statistically higher percentage (P < 0.001) of public sector obstetricians had negative perception of EA. CONCLUSION: Perception of obstetrician regarding EA is contrary to the current evidence. There is a need to introduce formal curriculum on …

Emerging Real-World Treatment Patterns and Clinical Outcomes of Multiple Myeloma in Argentina and Brazil: Insights from the TOTEMM Study in the Private Healthcare Sector.

As treatments for multiple myeloma (MM) evolve, there is a need for real-world insights into treatment patterns and outcomes. The treatment practices and clinical outcomes in patients with MM (TOTEMM) was a database study (2018-2024) of newly diagnosed transplant-ineligible patients with MM in Argentina (TOTEMM-A) and Brazil (TOTEMM-B) in a private healthcare setting. In TOTEMM-A (n = 72) and TOTEMM-B (n = 892), 37 and 92 different drug regimens were reported, respectively. In each country, treatment duration reduced across lines of therapy (LOT) (TOTEMM-A: range, 6.2-3.4 months; TOTEMM-B: ran

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… Between 2016 and 2021, the MYLACRE study reported a median OS of 48.7 months for patients in Latin America, representing those from the public and private sectors and those who have or have not undergone SCT [ 11 ]. …

Exploring the Financial Toxicities of Patients with Locally Advanced Head and Neck Malignancies, Being Treated in a Private Sector Hospital in North India: A Thematic Analysis.

BACKGROUND: The high cost of cancer diagnosis and treatment is a global concern. Evidence derived, mostly from high-income countries, shows how it gradually impacts the personal and household financial condition causing the increased psychosocial burden of the patient and their families (termed "financial toxicity"). AIM: To qualitatively explore the financial toxicities in patients with advanced head and neck malignancies in India, and to consider how it impacts the patient and his family. METHODS: Interviewing a purposive sample of 8 patients using semi-structured interviews face to face.

Comparison between public and private sectors of care and disparities in adverse neonatal outcomes following emergency intrapartum cesarean at term - A retrospective cohort study.

BACKGROUND: Perinatal outcomes may be influenced by a variety of factors including maternal demographics and medical condition as well as socio-economic status. The evidence for disparities in health outcomes stratified by type of care (public or private) is lacking. The aim of this study was to investigate short term neonatal outcomes following category 1 and 2 emergency cesareans at term between publicly and privately funded women at a single major tertiary centre in Australia. Category 1-immediate threat to life (maternal or fetal); Category 2-maternal or fetal compromise that is not immedi

Increased access to care and appropriateness of treatment at private sector drug shops with integrated management of malaria, pneumonia and diarrhoea: a quasi-experimental study in Uganda.

INTRODUCTION: Drug shops are a major source of care for children in low income countries but they provide sub-standard care. We assessed the feasibility and effect on quality of care of introducing diagnostics and pre-packaged paediatric-dosage drugs for malaria, pneumonia and diarrhoea at drug shops in Uganda. METHODS: We adopted and implemented the integrated community case management (iCCM) intervention within registered drug shops. Attendants were trained to perform malaria rapid diagnostic tests (RDTs) in each fever case and count respiratory rate in each case of cough with fast/difficul

Enablers and barriers to effective HIV self-testing in the private sector among sexually active youths in Nigeria: A qualitative study using journey map methodology.

BACKGROUND: HIV is a public health burden in Nigeria. HIV self-testing is one of the approaches to testing, which is the first of the 95:95: … ckage (Nvivo software). RESULTS: A journey map for taking up and effectively using HIVST using the private sector among sexually active youths using key enablers and barriers at the attract, purchase, use, confirmation, linkage, and reporting stage was developed. The major enablers among participants were privacy and confidentiality, bundling purchases with oth …

Treatment adherence status of the TB patients notified from private sector and its associated factors: Findings of a secondary data analysis from West Bengal, India.

INTRODUCTION: In India, each year, estimated one million TB cases are missing from notification, most of them being diagnosed treated in private sector. The large number of patients in private sector has raised concerns about suboptimal quality of care; lack of systems for treatment adherence thus raising the risk of drug resistance. The current analysis was conducted to find out the status of TB treatment adherence in private sector & to identify the factors associated with poor TB treatment adherence. METHODS: Analysis of secondary data obtained through adherence monitoring house visit by T…

Private sector tuberculosis care quality during the COVID-19 pandemic: a repeated cross-sectional standardised patients study of adherence to national TB guidelines in urban Nigeria.

Only a third of tuberculosis (TB) cases in Nigeria in 2020 were diagnosed and notified, in part due to low detection and under-reporting from the private health sector. Using a standardised patient (SP) survey approach, we assessed how management of presumptive TB in the private sector aligns with national guidelines and whether this differed from a study conducted before the start of the COVID-19 pandemic. 13 SPs presented a presumptive TB case to 511 private providers in urban areas of Lagos and Kano states in May and June 2021. Private provider case management was compared with national gui…

Is convenience really king? Comparative evaluation of catastrophic costs due to tuberculosis in the public and private healthcare sectors of Viet Nam: a longitudinal patient cost study.

BACKGROUND: In Viet Nam, tuberculosis (TB) represents a devastating life-event with an exorbitant price tag, partly due to lost income from daily directly observed therapy in public sector care. Thus, persons with TB may seek care in the private sector for its flexibility, convenience, and privacy. Our study aimed to measure income changes, costs and catastrophic cost incurrence among TB-affected households in the public and private sector. METHODS: Between October 2020 and March 2022, we conducted 110 longitudinal patient cost interviews, among 50 patients privately treated for TB and 60 TB …