Experiences of Private Sector Tuberculosis Patients in Patient-Provider Support Agency (PPSA) Implemented Districts of an Eastern Indian State

A BSTRACT Introduction: More than half of tuberculosis (TB) patients seek medical care at private facilities in India. Many models have been tried and tested for effective private-sector engagement in TB care. Patient-provider support agencies (PPSA) are the agencies that provide end-to-end TB care to private sector TB patients. Objectives: The main objective of this study was to capture TB patients’ experiences across the PPSA-implemented districts of Odisha. Methods: A mixed method design was adopted to study purposively selected beneficiaries across seven PPSA districts of Odisha, and cross-sectional survey and in-depth interview methods were adopted for quantitative and qualitative designs, respectively. Results: Of the 26 beneficiaries, 26.9% and 73.1% of beneficiaries first landed in private and public facilities, respectively; of them, 19.2% and 80.8% were microbiologically confirmed and clinically diagnosed, respectively. Similarly, 73.1% of the beneficiaries received their anti-TB drugs from the public sector, 76.9% received financial support from the program, and 34.6% of the beneficiaries incurred expenses out of their pocket in availing of TB-related services. Most of these patients admitted that they had received support from the operational PPSAs in their districts. Conclusions: PPSA agencies support private-sector patients in rendering public health action. The agencies contributed to both the supply side of the health system by improving the notification and aiding in other related services and to the demand side in rending the public health action.