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ORIGINAL ARTICLE
Open Access

STEPS: A Solution for Ensuring Standards of TB Care for Patients Reaching Private Hospitals in India

Shibu Balakrishnan, Rakesh PS, Sunilkumar M, Bhavan Sankar, Rakesh Ramachandran, Ameer KA, Ramani Gopi and Prem Nair
Global Health: Science and Practice June 2021, 9(2):286-295; https://doi.org/10.9745/GHSP-D-20-00449
Shibu Balakrishnan
aWorld Health Organization, National TB Elimination Program Technical Support Network, Cochin, Kerala, India.
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Rakesh PS
aWorld Health Organization, National TB Elimination Program Technical Support Network, Cochin, Kerala, India.
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  • For correspondence: rakeshrenjini@gmail.com
Sunilkumar M
bState TB Cell, Thiruvananthapuram, Kerala, India.
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Bhavan Sankar
cIMA END TB Project, Kerala, India.
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Rakesh Ramachandran
dProject JEET, State TB Cell, Kerala, India.
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Ameer KA
eCoalition of Professional Medical Associations for TB Elimination, Kerala, India.
fKerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India.
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Ramani Gopi
gInfection Control & STEPS, Renai Medicity, Cochin, Kerala, India.
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Prem Nair
hAmrita Institute of Medical Sciences, Cochin, Kerala, India.
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  • FIGURE 1
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    FIGURE 1

    STEPS Model for Private Sector Engagement in Kerala, India

    Abbreviation: STEPS, System for TB Elimination in Private Sector.

  • FIGURE 2
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    FIGURE 2

    Schematic Representation of STEPS Center Within a Hospital

    Abbreviation: STEPS, System for TB Elimination in Private Sector.

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    FIGURE 3

    Relationship of STEPS Center with the National TB Elimination Program

    Abbreviation: STEPS, System for TB Elimination in Private Sector.

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    TABLE

    Comparison of National TB Program Indicators Before and After Implementation of STEPS Model in Kerala, India

    Indicator20182019Percentage Change
    TB cases notified by the private sector, no.3,9815,003+26%
    Private specimens tested by public GeneXpert machines, no.7,87214,210+ 81%
    Microbiologically confirmed cases among notified TB, no. (%)995 (25%)1,951 (39%)+ 56%
    Patients notified of TB test results, no. (%)
        Patients tested for rifampicin resistance at baseline with GeneXpert637 (16%)1,951 (39%)+143%
        TB patients who know their HIV status1,672 (42%)4,102 (82%)+95%
        Patients received Direct Benefit Transfer1,273 (32%)3,552 (71%)+122%
        Patients whose treatment outcome was reported in Nikshay1,393 (39%)4,312 (86%)+120%
    Patients with TB treatment outcome reported, no. (%)
        Patients' treatment was completed successfully1,253 (90%)3,797 (88%)−2%
        Patients lost to follow-up31 (2%)87 (2%)0%
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Global Health: Science and Practice: 9 (2)
Global Health: Science and Practice
Vol. 9, No. 2
June 30, 2021
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STEPS: A Solution for Ensuring Standards of TB Care for Patients Reaching Private Hospitals in India
Shibu Balakrishnan, Rakesh PS, Sunilkumar M, Bhavan Sankar, Rakesh Ramachandran, Ameer KA, Ramani Gopi, Prem Nair
Global Health: Science and Practice Jun 2021, 9 (2) 286-295; DOI: 10.9745/GHSP-D-20-00449

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STEPS: A Solution for Ensuring Standards of TB Care for Patients Reaching Private Hospitals in India
Shibu Balakrishnan, Rakesh PS, Sunilkumar M, Bhavan Sankar, Rakesh Ramachandran, Ameer KA, Ramani Gopi, Prem Nair
Global Health: Science and Practice Jun 2021, 9 (2) 286-295; DOI: 10.9745/GHSP-D-20-00449
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  • Article
    • ABSTRACT
    • INTRODUCTION
    • TB ELIMINATION STRATEGIES IN KERALA
    • STEPS INTERVENTION MODEL FOR TB ELIMINATION IN THE PRIVATE SECTOR
    • EARLY RESULTS
    • KEY CHALLENGES FACED DURING IMPLEMENTATION
    • DISCUSSION
    • Acknowledgments
    • Funding
    • Author contributions
    • Competing interests
    • Notes
    • REFERENCES
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