Department of Community Medicine, Government Medical College Bhavnagar (Maharaja Krishnakumarsinhji Bhavnagar University), Bhavnagar, Gujarat, India.
Department of Physiology, Government Medical College Bhavnagar (Maharaja Krishnakumarsinhji Bhavnagar University), Bhavnagar, Gujarat, India.
Int J Health Plann Manage. 2021 Jul;36(4):1052-1068. doi: 10.1002/hpm.3151. Epub 2021 Mar 18.
Implementing the Standards for tuberculosis care in India (STCI) guidelines in the private sector is vital. This study attempted to estimate the knowledge and practices regarding STCI guidelines among private practitioners and to explore the reasons and solutions for low tuberculosis (TB) notification rates.
We conducted a cross-sectional study for assessing the knowledge and practices of the STCI guidelines among 100 full-time allopathic private practitioners in Bhavnagar (in western part of India) from September 2018 to January 2019. Knowledge and practice were categorised as good or poor by assigning scores to the responses to a questionnaire based on the STCI guidelines. It was followed by two focus group discussions to explore the reasons and solutions for low notification rates of TB as perceived by private practitioners.
Among the 100 private practitioners, 55% had good knowledge, and 41% had good practice regarding the STCI guidelines; 69% knew about the gazette notification of mandatory notification of TB, and 58% were notifying TB cases to the government. Lack of awareness about the process as well as incentives for notification, time constraints and infrequent visits by health workers were the main reasons perceived by private practitioners for not notifying TB cases to the government. The critical solutions suggested by them were creating awareness regarding the notification process as well as incentives, increasing health worker visits and use of social media for notification.
Only about half of private practitioners follow the STCI guidelines for TB care, and the notification rates are low in our setting. Regular sensitisation programs need to be arranged for private practitioners to create awareness on TB notification.
在私营部门实施印度结核病护理标准（STCI）指南至关重要。本研究试图评估私营部门执业医生对 STCI 指南的知识和实践情况，并探讨结核病（TB）低通报率的原因和解决方案。
我们于 2018 年 9 月至 2019 年 1 月在印度西部的巴夫那加尔（Bhavnagar）对 100 名全职西医私营执业医生进行了一项横断面研究，以评估他们对 STCI 指南的知识和实践情况。根据 STCI 指南，对问卷的回答进行评分，将知识和实践分为良好或不良。随后进行了两次焦点小组讨论，以探讨私营部门执业医生认为结核病低通报率的原因和解决方案。
在 100 名私营执业医生中，55%对 STCI 指南有良好的了解，41%有良好的实践；69%知道关于结核病强制通报的公报通知，58%向政府通报结核病病例。缺乏对通报程序以及通报激励措施的认识、时间限制和卫生工作者不常访问是私营部门执业医生认为未向政府通报结核病病例的主要原因。他们建议的关键解决方案是提高对通报程序以及激励措施的认识，增加卫生工作者的访问次数，并利用社交媒体进行通报。
只有大约一半的私营部门执业医生遵循 STCI 指南进行结核病护理，而且我们的环境中通报率较低。需要定期为私营部门执业医生安排宣传计划，以提高对结核病通报的认识。
