{
  "abstract": "Objective To evaluate the impact of public–private mix (PPM) models for tuberculosis (TB) on health, process and system outcomes, adopting the WHO’s definition of PPM, which is a strategic partnership between national TB programmes and healthcare providers, both public and private, to deliver high-quality TB diagnosis and treatment.Design Systematic review without meta-analysis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Data sources EMBASE, MEDLINE, Health Management Information Consortium, Social Sciences Citation Index, Science Citation Index, Emerging Sources Citation Index, CENTRAL, Database of Disability and Inclusion Information Resources, WHO Library Database and 3ie.Eligibility criteria We included all primary studies examining PPM models delivering TB services in urban health sectors in least-developed, low-income and lower–middle-income countries and territories.Data extraction and synthesis 17 reviewers were involved in data extraction in COVIDENCE using a prepiloted template. All extractions were completed by a single reviewer and checked by a second reviewer. Quality appraisal was carried out using the mixed-methods appraisal tool, covering mixed-methods, qualitative and quantitative study designs. Narrative synthesis was carried out by tabulating and summarising studies according to PPM models and reported in line with the synthesis without meta-analysis guidelines.Results Of the 57 included studies, covering quantitative (n=41), qualitative (n=6) and mixed-method (n=10) designs, the majority were from Southeast Asia (n=37). PPM models had overall positive results on TB treatment outcomes, access and coverage and value for money. They are linked with improved TB health workers’ skills and service delivery. Most outcomes tended to favour interface models, although with considerable heterogeneity. Inconsistent implementation of national TB guidelines, uncoordinated referrals and lack of trust among partners were identified as areas of improvement. Evidence was lacking on the involvement of informal providers within PPM models.Conclusions PPM models can be effective and cost-effective for TB care in urban low- and middle-income countries contexts, particularly when levels of mistrust between public and private sectors are addressed through principles of equal partnership. The evidence indicates that this may be more achievable when an interface organisation manages the partnership.PROSPERO registration number CRD42021289509.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Aishwarya Lakshmi Vidyasagaran"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Noemia Teixeira de Siqueira Filha"
    },
    {
      "affiliations": [
        "HERD International, Kathmandu, Nepal"
      ],
      "name": "Sampurna Kakchapati"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Thomas Falconer Hall"
    },
    {
      "affiliations": [
        "BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Baby Naznin"
    },
    {
      "affiliations": [
        "BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Jannatun Tajree"
    },
    {
      "affiliations": [
        "BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Zahidul Quayyum"
    },
    {
      "affiliations": [
        "HERD International, Kathmandu, Nepal"
      ],
      "name": "Deepak Joshi"
    },
    {
      "affiliations": [
        "Department of Nursing Science, Nnamdi Azikiwe University, Nnewi, Nigeria"
      ],
      "name": "Florence Tochukwu Sibeudu"
    },
    {
      "affiliations": [
        "Department of Psychology, Enugu State University of Science and Technology, Enugu, Nigeria"
      ],
      "name": "Pamela Adaobi Ogbozor"
    },
    {
      "affiliations": [
        "Department of Health Administration and Management, University of Nigeria, Nsukka, Nigeria"
      ],
      "name": "Ifeyinwa Ngozi Arize"
    },
    {
      "affiliations": [
        "HERD International, Kathmandu, Nepal"
      ],
      "name": "Grishu Shrestha"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Su Golder"
    },
    {
      "affiliations": [
        "ARK Foundation, Dhaka, Bangladesh"
      ],
      "name": "Maisha Ahsan"
    },
    {
      "affiliations": [
        "BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh"
      ],
      "name": "Swaksar Adhikary"
    },
    {
      "affiliations": [
        "Health Policy Research Group, University of Nigeria, Nsukka, Nigeria",
        "School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK"
      ],
      "name": "Prince Agwu"
    },
    {
      "affiliations": [
        "Department of Health Sciences, University of York, York, UK"
      ],
      "name": "Helen Elsey"
    }
  ],
  "title": "Public–private mix for tuberculosis in urban health systems in least-developed, low-income and lower–middle-income countries and territories: a systematic review",
  "uid": "eda3cada-1e8d-5abb-903d-d0275c3747e4"
}