| Research project on Integration of TB and HIV Services in India Approved |
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A new project investigating the current challenges and opportunities for the integration of TB and HIV services for co-infected patients in Pune, India, has been approved by the Evidence for Action Programme Management Committee. The work will be a collaboration between London School of Hygiene and Tropical Medicine, Maharashtra Association of Anthropological Sciences, and National AIDS Research Institute, India. India was one of the first countries in the world to bring out TB/HIV management guidelines jointly prepared by the National TB and HIV/AIDS programmes in 2001, almost as soon as the two programmes recognised co-infection to be a major problem. Coordination activities were launched in the same year in the six high prevalence states and extended to a further eight states in 2004. While there is on-going operational revision of the systems for delivery, referrals and documentation of care in response to initial challenges faced, there is not much evidence to demonstrate how the coordination of programme activities impacts on health seeking and care outcomes for co-infected patients in the public sector. The presence of a large private sector, which plays a major role in the management of TB and HIV, further complicates the health-seeking pathways of co-infected patients. The project aims to give us a better understanding of the current situation and prospects for integrating TB and HIV care from a programme manager, a provider, and a patient perspective, in the city of Pune, Maharashtra. To this purpose, we will conduct qualitative health systems research in two phases over a six-month period. In the first phase, interviews will be conducted with key informants in the public, private and NGO sector and with health providers to identify challenges and opportunities for HIV and TB programme collaboration. In the second phase, we will conduct in-depth interviews with known co-infected patients under care in the public, private and NGO sectors, in order to identify key issues in their awareness, decision-making and experiences of care-seeking for TB and HIV. |