Scaling up tuberculosis case finding via private providers in Ghana

An impact evaluation using interrupted time series

Bibliographic Data

ID22069066
AuthorsKenneth Mawuta Hayibor (0000-0002-5451-7860, University of Ghana, corresponding author), Ernest Kenu (0000-0001-8007-0073, University of Ghana), Gloria Ivy Mensah (0000-0002-6499-5946, University of Ghana), Dziedzorm Awalime (Ghana Institute of Languages), Jabina Anaman (Ghana Institute of Languages), Adwoa Asante-Poku (0000-0001-8929-193X, University of Ghana), Olena Ivanova (0000-0002-8276-7891, Ludwig-Maximilians-Universität München), Bakuli Abhishek, Andrea Rachow (0000-0003-4729-3405, Helmholtz Zentrum München), Nii Nortey Hanson-Nortey (0000-0003-3595-2987, Ghana Institute of Languages), Nortey Nii Hanson-Nortey
Year2025
Volume13
Pages1598269-1598269
Publication date2025-08-26
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1598269
PMID40933408
OpenAlexW4413614379
LanguageEN
References cited31

Background: Although TB services are free in Ghana, TB case detection remains low and mostly limited to public facilities. To address this, a Public-Private Mix (PPM) Directly Observed Therapy (DOT) model was introduced, involving community private healthcare providers and the National Health Insurance Scheme (NHIS) to boost TB case detection rates. Methods: This impact evaluation focuses on four key interventions targeting vulnerable populations in Ghana's two largest metropolitan areas between the last quarter of 2018 and the first quarter of 2020. Screening and TB register data were collected from implementing facilities, along with TB case notifications from 2015 to 2022 for both intervention and control areas. Comparative interrupted time series (ITS) analysis was used to evaluate the effect of the interventions on quarterly TB case notifications. Results: During the intervention period, a total of 563,868 persons were screened for TB, 12,121 of these were presumptive for TB and 590 persons were diagnosed with TB. Of the diagnosed TB cases, 95.3% (562) were bacteriologically confirmed. The overall TB screening yield was 104.6 cases per 100,000 population. In the intervention area, TB case notifications increased from 1,392 cases in 2018 to 1,462 cases in 2019 while they decreased from 853 to 778 in the control area. The ITS analyses detected positive post-intervention trend differences in all forms of TB and bacteriologically confirmed TB notification case rates between the intervention and control areas. Conclusion: Expanding free TB services through a PPM DOT model and sustained community engagement can increase TB case detection in urban areas. National TB programs should adopt and scale this approach to enhance TB surveillance and control

Interrupted time series · Interrupted Time Series Analysis · Psychological intervention · Statistics · Time series · Tuberculosis · Computer Science · Healthcare Facilities Design and Sustainability · Healthcare Systems and Reforms · Medicine · Nursing · Tuberculosis Research and Epidemiology

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