# Private Doctors’ Perspective towards “Patient First” in TB Diagnostic Cascade, Hisar, India

## TL;DR

The study explores how private doctors in India adopt a patient-first approach in TB diagnosis and evaluates a new diagnostic model in Hisar.

## Contribution

The study introduces and evaluates the One-Stop TB Diagnostic Solution model in strengthening private diagnostics for TB.

## Key findings

- 32% of specimens tested positive for TB and 7% showed rifampicin resistance.
- Thirty private doctors expressed satisfaction with the patient-centric diagnostic model.
- The model highlights the need for certification to ensure quality TB diagnostics in private settings.

## Abstract

TB diagnosis has been simplified in India following advances in available diagnostic tools. This facilitates private doctors’ “patient first” approach toward early diagnosis; however, costs remain high. India’s NTEP established a TB diagnostic network, which is free for patients and incentivizes private doctors to participate. Drawing from this context led to the design and implementation of the One-Stop TB Diagnostic Solution model, which was conducted in the Hisar district, Haryana, allowing specimens from presumptive TB patients from private doctors to be collected and tested as per NTEPs diagnostic algorithm. A subset of data pertaining to private doctors was analyzed for the project period. Qualitative data were also collected by interviewing doctors using a snowball method to capture doctors’ perception about the model. Out of 1159 specimens collected from 60 facilities, MTB was detected in 32% and rifampicin resistance was detected in 7% specimens. All specimens went through the diagnostic algorithm. Thirty doctors interviewed were satisfied with the services offered and were appreciative of the program that implements this “patient centric” model. Results from implementation indicate the need to strengthen private diagnostics through a certification process to ensure provision of quality TB diagnostic services.