Quality of care for tuberculosis and HIV in the private health sector: a cross-sectional, standardised patient study in South Africa

Summary


Published April 2021.

Background

South Africa has high burdens of tuberculosis (TB) and TB-HIV, yet the quality of patient care in the private sector is unknown. We describe quality of TB and TB-HIV care among private general practitioners (GPs) in two South African cities using standardised patients (SPs).

Methods

Sixteen SPs presented one of three cases during unannounced visits to private GPs in selected high-TB burden communities in Durban and Cape Town: case 1, typical TB symptoms, HIV-positive; case 2, TB-specified laboratory report, HIV-negative and case 3, history of incomplete TB treatment, HIV-positive. Clinical practices were recorded in standardised exit interviews. Ideal management was defined as relevant testing or public sector referral for any reason. The difference between knowledge and practice (know-do gap) was assessed through case 1 vignettes among 25% of GPs. Factors associated with ideal management were assessed using bivariate logistic regression.

Conclusions Private providers ideally managed TB more often when a diagnosis or history of TB was implied or provided. Management of HIV in the context of TB was less than optimal.

Citation

Boffa, J., Moyo, S, Chikovore, J., Salomon, A., Daniels, B., Kwan, A. T., Pai, M. & Daftary, A. (2021). Quality of care for tuberculosis and HIV in the private health sector: a cross-sectional, standardised patient study in South Africa. BMJ Global Health, 6(5).

Tags HIV/AIDS
Geographies South Africa

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