Enhancing TB case detection: a case study of Kenya's Global Fund-supported public-private mix

Background Kenya, a high-TB-burden country, is among eight WHO-priority countries for public-private mix (PPM) initiatives to engage all health care providers in TB prevention and care. Objective To describe Kenya's experience implementing a Global Fund-supported PPM intervention and its contribution to TB case finding. Design A descriptive case study using programmatic data from a Global Fund-supported PPM project implemented in nine counties in Kenya. Results Of 2,027 mapped facilities, 1,405 signed Memoranda of Understanding and 1,269 reported TB services. Of 4.3 million people screened, 260,922 (6%) were identified as presumptive TB, of whom 108,723 (42%) were investigated. Overall, 14,026 individuals were diagnosed with TB (64% bacteriologically confirmed), and 99% initiated on treatment. Level II facilities contributed 45% of notifications (7 per facility), while Level V facilities (only 4) reported the highest average yield (130 per facility). All counties recorded increased TB notifications during implementation, followed by a decline in Quarter 3, 2024. Conclusion Engaging private sector providers significantly enhanced TB case detection. Kenya's PPM experience highlights the engagement choices that need to be made among levels of the health care system for scaling and sustaining PPM models in resource-constrained settings.