United Against Tuberculosis: Ghana's Private and Public Health Sectors Join Forces

Zawya

24-03-2025

For weeks, Mansah, a resident of a suburb of Kumasi, Ghana's second-largest city, had been battling a persistent cough, fever, and unexplained weight loss. Fear gnawed at her- she suspected Tuberculosis (TB), a disease she knew could have serious consequences. Seeking a diagnosis and treatment at a public health facility would have meant spending nearly an entire day navigating long queues, a challenge given her demanding job. Like many others, she preferred seeking medical care at a private facility, even though TB services were traditionally not readily available there.
For over a decade, Ghana had struggled to increase TB case notifications with annual detections stagnant at around 15,000 cases-leaving an estimated 60% of cases infections undiagnosed and untreated. This meant that thousands of people with TB were not receiving the care they needed, fueling the spread of the disease.
However, a new initiative by the National Tuberculosis Program (NTP) is rewriting the narrative. Through a Private-Public Mix (PPM) approach, free TB diagnostic and treatment services are now integrated into private healthcare facilities, bringing communities closer. This means that individuals like Mansah can now receive TB diagnosis and treatment at private health centers in their neighborhoods—free of charge.
Implemented by Aurum Institute Ghana under the guidance of the National Tuberculosis Control Program, with technical support from the World Health Organization (WHO) and funding from the Global Fund, this initiative is making significant strides. In its first year alone, it has contributed 602 TB cases, representing 3% of the 20,154 TB cases notified nationally in 2024—a critical step toward closing the gap on 'missing' TB cases.
Since implementation began in 2024, the project has achieved the following:
Training 375 private health workers on TB screening, diagnosis, treatment, and psychosocial support.
i. Equipping 20 private health facilities with GeneXpert machines for rapid TB diagnosis.
ii. Providing essential logistics and medical supplies in line with national TB protocols.
iii. Implementing on-site coaching and mentorship programs through targeted supportive supervision.
iv. Verifying and validating TB cases through rigorous data auditing.
v. Enrolling 98% of diagnosed TB patients onto treatment to ensure continuity of care.
vi. Engaging key professional health associations, including the Association of Private Medical and Dental Practitioners, Community Practice Pharmacists Association, Over-the-Counter Medicine Sellers Association, and Private Health Association of Ghana, to sustain the intervention.
A key innovation of this initiative is the deployment of 37 TB Champions—individuals who have been successfully treated for TB—to work with over-the-counter medicine sellers and pharmacies. These champions are trained to:
i. Support TB screening, sputum collection, and transportation for testing at pharmacies and medicine outlets.
ii. Follow up with positive cases, ensuring they are linked to care and supported through treatment adherence.
iii. Conduct contact tracing and enroll eligible individuals in TB Preventive Treatment (TPT) programs.
iv. Provide psychosocial support, helping to reduce stigma and promote early diagnosis.
Notably, TB screening services at pharmacies and over-the-counter medicine sellers contributed 10% of the total TB cases notified by the private sector in 2024.
WHO has played a crucial role in providing technical support, particularly in fostering collaboration between district health managers and private sector providers to ensure long-term sustainability. This has significantly improved working relationships between public and private health facilities, with private hospitals now serving as GeneXpert testing sites for public health facilities in implementing districts.
For Mansah and countless others who rely on private healthcare, TB diagnostic and treatment services are now more accessible than ever. The initiative continues to evolve, incorporating additional elements such as expanded contact investigations and TB preventive treatment—interventions previously dominated by the public health sector due to workforce limitations in private facilities.
With continued collaboration between public and private sectors, Ghana is making meaningful progress towards ending TB as a public health threat—ensuring that no one, regardless of where they seek healthcare, is left behind.
Distributed by APO Group on behalf of World Health Organization (WHO), Ghana.