SHORT TERM ADVANTAGES OF A PUBLIC-PRIVATE PARTNERSHIP FOR TUBERCULOSIS IN GUINEA BISSAU: REDUCTION OF MORTALITY AND INCREASED DIAGNOSTIC CAPACITY

Main Article Content

Fina Vieira
Mamadu Saliu Sanha
Fabio Riccardi
Raffaella Colombatti *
(*) Corresponding Author:
Raffaella Colombatti | rcolombatti@gmail.com

Abstract

Background: Tuberculosis (TB) is widespread in Africa, but weak health systems in developing countries, often display poor quality of care with delays in case identification, irrational therapy and drug shortage, clinical mismanagement, unnecessary expenditures for patients, reduced adherence and increased mortality. Public-private partnership has demonstrated to increase TB case detection, but less is known about its effects on quality of care, mortality and costs for hospitalized TB patients.

Methods: Clinical outcomes and costs for TB patients at the TB National Reference Center of Bissau, in Guine Bissau, West Africa were determined during the first 5 months of the public-private management and compared to the ones of previous years when the hospitals was under  direct Government’s management.

Results: 215 (2009) and 194 (2013) patients were admitted, respectively. Improvement (p<0.05) was observed in mortality reduction (21% vs 6%), analysis prescription and diagnosis (39% vs 100%), cause of death determination (50% vs 85%), treatment abandonment (15 vs 1). Direct costs for patients during TB diagnostic pathway and inpatient care were significantly reduced, 475 vs 0 USD.

Conclusions: Public-private partnerships displays important short term benefits in National TB reference centers, even in post-conflict and low-resource countries. Further studies could aid in determining the overall long term benefits of  this type of cooperation and the specific characteristic of TB and concomitant hematologic and infectious diseases in TB admitted patients.


Downloads month by month

Downloads

Download data is not yet available.

Article Details

Author Biographies

Fina Vieira, Hospital Raoul Follereau

Mamadu Saliu Sanha, Hospital Raoul Follereau, Aid Health and Development

Fabio Riccardi, Università di Tor Vergata

Raffaella Colombatti, Clinic of Pediatric Hematology-Oncology, Department of Pediatrics, Azienda Ospedaliera-Università di Padova, Padova, Italy.