Using “Mystery Clients” to Examine TB Care Quality in Lagos and Kano – Key Findings

The World Health Organization classifies Nigeria as a high burden country for TB. The private health sector can play a potentially large role in increasing the case detection of TB. SHOPS Plus has been working with Nigeria’s National TB and Leprosy Control Programme (NTBLCP) since 2018 to implement a multi-cadre public-private mix model in Lagos and Kano to expand the availability of TB services and increase TB detection, notification, and treatment. The project conducted a study to evaluate the extent that private PPMVs, community pharmacies, laboratories, and clinical facilities it trained to provide TB services were adhering to national guidelines and standards for management of presumptive and confirmed TB. Despite bottlenecks related to the collection of sputum samples for diagnosis of TB and counseling for newly confirmed patients, SHOPS Plus private provider cadres managed mystery clients as well as or better than public TB directly observed treatment facilities.