Ending tuberculosis in Nigeria through provider networks and behavior change

The SHOPS Plus team in Nigeria announces a new effort to capitalize on the growing private health care sector to end tuberculosis. The team will kick off the new program at World Tuberculosis Day events in Lagos and Kano states on March 24.

According to the World Health Organization, Nigeria is a high burden country for TB and also has one of the lowest case detection rates among high TB burden countries with just 15 percent of the incident cases being notified. Although the private health sector in Nigeria is a major source for health care, TB treatment is largely restricted to the public sector so the private health sector represents an untapped resource for combating TB. 

The SHOPS Plus project is working with the national TB program and private providers in Lagos and Kano states to build a network of private providers in each state, including proprietary patent medicine vendors, private laboratories, community pharmacists and clinician-owned facilities, that will rapidly increase the case detection rate for TB. The project will work with the networks to strengthen clinical TB skills, increase collection and use of TB service delivery data for program improvement and boost performance by implementing effective private sector incentives such as improved access to finance and enabling access to public sector TB commodity supply chains.

Networks will address the independent and somewhat isolated nature of most private sector facilities by linking the providers with each other and with the state/national TB control programs, thereby allowing SHOPS Plus to strengthen regular supervision and capacity building in TB case detection, treatment, and follow-up. The networks will be supported by intermediary organizations contracted by SHOPS Plus who will coordinate with Lagos and Kano State TB programs and the National Tuberculosis and Leprosy Control Program.

To raise awareness about TB and encourage health seeking behavior, SHOPS Plus will develop a targeted social behavior change strategy to address societal barriers such as stigma and individual care seeking behaviors such as openness to seeking diagnosis, follow through with referrals, and adherence to treatment.  

Using a model developed in India under its predecessor project, SHOPS Plus will work to increase TB case detection and the quality of TB care available through the private sector.  The activity promises to be a good example of south-south learning and engagement.