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A social enterprise model for TB detection and treatment through the private sector in Pakistan

Zaidi, SMA; Jamal, WZ; Ibrahim, U; Khowaja, S; Khan, AJ; Creswell, J; (2024) A social enterprise model for TB detection and treatment through the private sector in Pakistan. IJTLD OPEN , 1 (2) pp. 63-68. 10.5588/ijtldopen.23.0376. Green open access

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Abstract

BACKGROUND : Existing models to increase TB case notifications from the private sector in Pakistan are financially unsustainable and have achieved modest success due to limited coverage. OBJECTIVE : To evaluate the impact of a social enterprise model (SEM) intervention on TB case detection in Karachi, Pakistan, and to assess its financial sustainability. METHODS : Purpose-built centres were established within the private sector that integrated TB screening, diagnostics and treatment and operated 12 hours per day with convenient locations to improve access. TB services were offered free of cost, and revenue generation took place through user fees from other diagnostics. Private providers with a focus on the informal sector were engaged through community workers to generate screening referrals. RESULTS : Overall 171,488 people were screened and 18,683 cases were notified, including 197 individuals with drug-resistant TB. Annual TB notifications in Karachi increased from 18,105 in 2014 to a maximum of 25,840 (40% increase). The proportion of cases in Karachi notified by the centres grew to 27% in 2020. Commercial revenue reached USD288,065 and enabled operating cost recovery of 15%. Average cost per TB case notified was USD203. CONCLUSION : The SEM intervention contributed a large proportion of notifications in Karachi and achieved modest cost recovery.

Type: Article
Title: A social enterprise model for TB detection and treatment through the private sector in Pakistan
Open access status: An open access version is available from UCL Discovery
DOI: 10.5588/ijtldopen.23.0376
Publisher version: http://dx.doi.org/10.5588/ijtldopen.23.0376
Language: English
Additional information: This article is Open Access under the terms of the Creative Commons CC BY licence. https://creativecommons.org/licenses/by/4.0/
Keywords: social business; social entrepreneurship; sustainability; health systems; public–private mix
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10188215
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