Screening patients for TB at Pharmacies in Nepal | Initiative by TBPPM

TBPPM is an online community of practice focused on engaging private providers in TB care. As part of sharing voices from the frontline through the community, TBPPM had published innovative practices and projects in TB care throughout the world. The recent and one of the good initiation is about the initiative taken by National Tuberculosis Control Center of Nepal and ‘Save the Children’ to engage pharmacies in screening and referring TB patients.

The National TB Control Center and ‘Save the Children’ organization in Nepal utilized the Global fund and implemented a ‘hub and spoke’ referral mechanism in October 2019. This referral mechanism involved 385 pharmacies from various districts: Kathmandu, Lalitpur, Bharatpur, Birgunj, Biratnagar metropolitan city and Nepalgunj sub-metropolitan city. The main aim of the project is to ensure that all the presumptive TB patients who approached local pharmacies benefited from screening, diagnosis, and treatment in accordance with the national guidelines. The private sector including pharmacy is generally profit-oriented. Even this incentive may not be lucrative for screening and referring as it takes more time for screening, counseling and record-keeping. Hence the pharmacists selectively screen more probable patients thereby the overall number of referral cases is less than expected. Therefore, offering additional personnel or additional incentive would increase the referral.

Key findings: From October 2019 to November 2020 out of the 1,949 patients screened by the pharmacies (Spoke) 443 patients were diagnosed with having TB (23%) and referred to 85 Hubs (including private practitioners and FAST hospital).

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Key takeaways:

1. The National TB Control Center and ‘Save the Children’ organization in Nepal utilized the Global fund and implemented a ‘hub and spoke’ referral mechanism in October 2019.

2. This referral mechanism involved 385 pharmacies from various districts in Nepal to screen and identify patients with TB who present to the pharmacy and may normally be missed under the national program

3. 23% of patients notified by these pharmacies over a period of one year, were diagnosed to have TB.

References: Pharmacy Referral System in Nepal, TBPPM

Pharmacy Referral System in Nepal