This eBook is dedicated to the millions of people who battle TB every year We hope they get the high-quality care they need and deserve To view individual articles in the series on Quality of Tuberculosis Care, visit the Journal website: https://www.sciencedirect.com/journal/journal-of-clinical-tuberculosis-and-other- mycobacterial-diseases/special-issue/10JL8LN0VVT Articles in this series are published under CC BY-NC-ND license, and be shared/copied, with credit, for non-commercial purposes only Contents lists available at ScienceDirect J Clin Tuberc Other Mycobact Dis journal homepage: www.elsevier.com/locate/jctube Quality of Tuberculosis Care Table of Contents T 1. Quality: The missing ingredient in TB care and control Madhukar Pai, Zelalem Temesgen 2. Lessons on the quality of tuberculosis diagnosis from standardized patients in China, India, Kenya, and South Africa Benjamin Daniels, Ada Kwan, Madhukar Pai, Jishnu Das 3. Quality of drug-resistant tuberculosis care: Gaps and solutions Zarir Udwadia, Jennifer Furin 4. In the eye of the multiple beholders: Qualitative research perspectives on studying and encouraging quality of TB care in India Andrew McDowell, Nora Engel, Amrita Daftary 5. Measuring and improving the quality of tuberculosis care: A framework and implications from the Lancet Global Health Commission Catherine Arsenault, Sanam Roder-DeWan, Margaret E. Kruk 6. Implementing quality improvement in tuberculosis programming: Lessons learned from the global HIV response Daniel J. Ikeda, Apollo Basenero, Joseph Murungu, Margareth Jasmin, Maureen Inimah, Bruce D. Agins 7. Quality of TB services assessment: The unique contribution of patient and provider perspectives in identifying and addressing gaps in the quality of TB services Charlotte Colvin, Gretchen De Silva, Celine Garfin, Soumya Alva, Suzanne Cloutier, Donna Gaviola, Kola Oyediran, Tito Rodrigo, Jeanne Chauffour 8. The high-quality health system ‘revolution’: Re-imagining tuberculosis infection prevention and control Helene-Mari van der Westhuizen, Ruvandhi R. Nathavitharana, Clio Pillay, Ingrid Schoeman, Rodney Ehrlich 9. Quality of life with tuberculosis Ashutosh N. Aggarwal 10. Quality of TB care among people living with HIV: Gaps and solutions Kogieleum Naidoo, Santhanalakshmi Gengiah, Satvinder Singh, Jonathan Stillo, Nesri Padayatchi 11. Closing gaps in the tuberculosis care cascade: an action-oriented research agenda Ramnath Subbaraman, Tulip Jhaveri, Ruvandhi R. Nathavitharana 12. Quality matters: Redefining child TB care with an emphasis on quality Farhana Amanullah, Jason Michael Bacha, Lucia Gonzalez Fernandez, Anna Maria Mandalakas 20. Quality of tuberculosis care in the private health sector 21. Improving the quality of tuberculosis care in the post-pandemic world Contents lists available at ScienceDirect J Clin Tuberc Other Mycobact Dis journal homepage: www.elsevier.com/locate/jctube Quality of Tuberculosis Care Table of Contents T 13. Quality of tuberculosis care by pharmacies in low- and middle-income countries: Gaps and opportunities Rosalind Miller, Catherine Goodman 14. Implementation science to improve the quality of tuberculosis diagnostic services in Uganda Adithya Cattamanchi, Christopher A. Berger, Priya B. Shete, Stavia Turyahabwe, Moses Joloba, David AJ Moore, Lucian J. Davis, Achilles Katamba 15. Identifying gaps in the quality of latent tuberculosis infection care Hannah Alsdurf, Dick Menzies 16. User experience and patient satisfaction with tuberculosis care in low- and middle-income countries: A systematic review Danielle Cazabon, Tripti Pande, Paulami Sen, Amrita Daftary, Catherine Arsenault, Himani Bhatnagar, Kate O'Brien, Madhukar Pai 17. Tuberculosis deaths are predictable and preventable: Comprehensive assessment and clinical care is the key Anurag Bhargava, Madhavi Bhargava 18. Improving quality is necessary to building a TB-free world: Lancet Commission on Tuberculosis Michael J.A. Reid, Eric Goosby 19. What quality of care means to tuberculosis survivors Chapal Mehra, Debshree Lokhande, Deepti Chavan, Saurabh Rane 20. Quality of tuberculosis care in the private health sector Guy Stallworthy, Hannah Monica Dias, Madhukar Pai 21. Improving the quality of tuberculosis care in the post-pandemic world Jacob Bigio, Angelina Sassi, Zelalem Temesgen, Madhukar Pai 20. Quality of tuberculosis care in the private health sector 21. Improving the quality of tuberculosis care in the post-pandemic world J Clin Tuberc Other Mycobact Dis 14 (2019) 12–13 Contents lists available at ScienceDirect J Clin Tuberc Other Mycobact Dis journal homepage: www.elsevier.com/locate/jctube Editorial Quality: The missing ingredient in TB care and control T Good health is a function of the utilization of healthcare services TB field urgently needs to adopt and implement the science of quality and the quality of healthcare. In the field of global health, there is improvement (QI). But QI alone is not sufficient, since even the foun- growing awareness of the need to go beyond coverage of services and dations of TB care are weak. Countries need to invest adequate funds to improve the quality of care [1,2]. control TB, and make sure TB services are of high quality and patient- Recently, The Lancet Global Health published a landmark report centric. entitled High-quality health systems (HQSS) in the Sustainable In September 2018, the United Nations General Assembly hosted the Development Goals era: Time for a revolution [3]. In this HQSS Com- first ever High-level Meeting (UNHLM) on TB, and adopted a political mission report, the authors asserted that providing health services (i.e. declaration, which recognized that “tuberculosis is both preventable coverage) without guaranteeing a minimum level of quality is in- and curable, yet 40 per cent of people newly a ffected by tuberculosis effective, wasteful, and unethical. What is needed, the Commission are missed by public health reporting systems, and millions do not re- argued, are high-quality health systems that optimize health care in ceive quality care each year, and that tuberculosis can only be elimi- each given context by consistently delivering care that improves or nated through prevention efforts and access to quality diagnosis, maintains health, by being valued and trusted by all people, and by treatment and care, including access to affordable diagnostic tools and responding to changing population needs [3]. drug treatment, effective people-centered and community-based Throughout the report, tuberculosis (TB) is used as a key example to models of care supported by integrated care services, as well as finan- illustrate the need to go beyond coverage and focus on the quality of cing innovations” [14]. care. According to the HQSS report, more than 8 million people per The TB field must build on this emphasis on quality in the UNHLM year in low- and middle-income countries die from conditions that declaration and push all stakeholders to think beyond coverage and should be treatable by the health system. Sixty-percent of deaths from demand high quality care for all TB patients in all countries. If we are conditions amenable to health care are due to poor-quality care, serious about ending TB, we must put quality on the agenda, in addition whereas the remaining deaths result from non-utilization of the health to expanding coverage of critical interventions. system [3]. Given the importance of quality in TB care, Journal of Clinical The HQSS report provides a detailed analysis on TB deaths. Of the Tuberculosis and Other Mycobacterial Diseases, has launched a series on 946,003 TB deaths amenable to healthcare, the authors estimate that this topic. The series will cover papers on quality of TB care, approaches 469,956 (50%) are due to poor quality TB care. The remaining 476,047 to measuring quality, and quality improvement interventions. It is our deaths are due to non-utilization of healthcare services [3]. wish and hope that this series will result in a robust and sustained The report suggests that high-quality health systems could prevent conversation about quality TB care, a topic that has heretofore been 900,000 TB deaths each year [3]. In other words, by using already woefully neglected. existing tools and improving the quality of care, we can avert 50% of all TB deaths. Conflicts of interest The fact that 50% of deaths in association with TB occur despite the patient seeking medical care is a sad reflection on the current state of None. affairs. How is it acceptable that we cannot save patients with a curable, bacterial infection for which we have policies, tools and technologies? Ethical statement Why is the quality of TB care suboptimal? Patient-pathways ana- lyses from 13 countries show long, complex pathways to health care, None. private or informal sectors being the preferred first point of contact, and lack of adequate TB services at the primary care level. [4] Several Supplementary material studies show large gaps in the cascades of care, across types of TB and countries [5–7]. Supplementary material associated with this article can be found, in Simulated (standardized) patient studies in 4 countries (India, the online version, at doi:10.1016/j.jctube.2018.12.001. Kenya, China and South Africa) confirm gaps in cascades of care, and show poor quality of care in both public and private sectors, with pri- References vate sector faring worse [8–12]. Across these studies, only about a third of simulated patients with presumed TB were managed correctly at the [1] Kruk ME, Larson E, Twum-Danso NA. Time for a quality revolution in global health. primary care level. Lancet Glob Health 2016;4(9):e594–6. [2] Das J, Woskie L, Rajbhandari R, Abbasi K, Jha A. Rethinking assumptions about To end TB, we need nothing short of a quality revolution [13]. The https://doi.org/10.1016/j.jctube.2018.12.001 Received 29 November 2018; Accepted 23 December 2018 2405-5794/ © 2018 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/). Editorial J Clin Tuberc Other Mycobact Dis 14 (2019) 12–13 delivery of healthcare: implications for universal health coverage.