Cost and outcomes of drug-susceptible TB treatment at public and private primary healthcare clinics, Johannesburg South Africa

By  Sharon Kgowedi  Sarah Girdwood  Kerensa Govender  Nkgomeleng Lekodeba  Dr Gesine Meyer-Rath  Dr. Jacqui Miot  Dr. Lawrence Long  |  | 

South Africa carries 3% of the world’s tuberculosis (TB) case burden and is experiencing a dual TB/HIV epidemic: 59% of adult TB patients are also HIV positive.[1] There are no recent published estimates on the costs and outcomes of drug-susceptible TB in South Africa for adults in an out-patient setting with the exception of one paper published in 2003 (using 1997 data) [2] and another in 2006 (using 2001 data) [3].
The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) provision in South Africa, relying on a mix of public and private providers. TB services in South Africa are largely domestically funded (87%) and publicly provided[1] with private sector TB treatment mostly limited to those private organisations that can access medicines at state sector contract prices and occupational health organisations at mines.[4] We conducted a cost-outcome analysis to explore the possible implications of expanding TB access using private providers.

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