Background: Public and private health sectors both play a crucial role in the health systems of low- and middleincome countries (LMICs). The tuberculosis (TB) control strategy in India encourages the public sector to actively
partner with private practitioners (PPs) to improve the quality of front line service delivery. However, ensuring
effective and sustainable involvement of PPs constitutes a major challenge. This paper reports the findings from
an empirical study focusing on the perspectives and experiences of PPs towards their involvement in TB control
programme in India.
Methods: The study was carried out between November 2010 and December 2011 in a district of a Southern Indian
State and utilised qualitative methodologies, combining observations and in-depth interviews with 21 PPs from
different medical systems. The collected data was coded and analysed using thematic analysis.
Results: PPs perceived themselves to be crucial healthcare providers, with different roles within the public-private
mix (PPM) TB policy. Despite this, PPs felt neglected and undervalued in the actual process of implementation of
the PPM-TB policy. The entire process was considered to be government driven and their professional skills and
knowledge of different medical systems remained unrecognised at the policy level, and weakened their relationship
and bond with the policy and with the programme. PPs had contrasting perceptions about the different components
of the TB programme that demonstrated the public sector’s dominance in the overall implementation of the DOTS
strategy. Although PPs felt responsible for their TB patients, they found it difficult to perceive themselves as ‘partners
with the TB programme.’
Conclusion: Public-private partnerships (PPPs) are increasingly utilized as a public health strategy to strengthen
health systems. These policies will fail if the concerns of the PPs are neglected. To ensure their long-term involvement
in the programme the abilities of PPs and the important perspectives from other Indian medical systems need to be
recognised and supporte