{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:49:09Z","timestamp":1788400149586,"version":"build-2803163510"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Tuberculosis (TB) case reporting is vital for national and subnational surveillance and is mandated in India since 2012. All health providers, public and private, must report through the web-based system, \u201cNikshay.\u201d The prevalence: notification ratio from 2019 to 2021 was 2.84 (prevalence was almost 3 times the notification), suggesting under-notification. This study explores the experiences, identifies barriers and facilitators, and examines perceptions regarding mandatory notification and incentives among private providers (PPs) in diverse contexts in Bengaluru city.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Focused group discussions were held with specialist faculty of Pediatrics, Internal Medicine, and Pulmonology across three medical colleges and in-depth interviews included freelancing specialists and general practitioners. Data was collected in Bengaluru from January 2018 to July 2019, analyzed using a framework approach, referencing social learning theory, precede\/proceed model, and theory of learned behavior. Thematic content analysis linked emerging themes to codes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was unmet expectation regarding lack of feedback from the NTEP regarding the patients notified. Emphasis on bacteriological diagnosis for every patient by NTEP deterred notification. Incentives were felt either to be insufficient for doctors or the PPs felt they were obliged to the national programme to notify. Barriers included obligation to maintain confidentiality, stigma, lack of knowledge of how to notify and facilitators included being recognized for their efforts and implementation of compulsory notification in letter and spirit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Strategies to minimize stigma through education of patients at diagnosis and regular communication with private providers about the notification process, guidelines, and policy improvements can decrease resistance to notification. Recognizing best practices and rewarding on professional platforms could motivate private providers, alongside continued monetary incentives. Finally, demonstrating effective implementation of mandatory notification provision may boost private providers\u2019 morale.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1531069","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T11:14:22Z","timestamp":1743765262000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["What ails tuberculosis notification from the private sector in urban India: a qualitative study among stakeholders in Bengaluru City, southern India"],"prefix":"10.3389","volume":"13","author":[{"given":"Anand D.","family":"Meundi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Hendrik","family":"Richardus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"ref1","year":"2023"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"S33","DOI":"10.1016\/j.ijtb.2020.11.006","article-title":"Surveillance of tuberculosis","volume":"67","author":"Schwoebel","year":"2020","journal-title":"Indian J Tuberc"},{"key":"ref3","year":"2012"},{"key":"ref4","year":"2023"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1111\/tmi.13574","article-title":"TB notification rates across parliamentary constituencies in India: a step towards data-driven political engagement","volume":"26","author":"Pardeshi","year":"2021","journal-title":"Trop Med Int Health"},{"key":"ref6","year":""},{"key":"ref7","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.ijtb.2021.04.001","article-title":"Tuberculosis notification: an inquiry among private practitioners in Pimpri-Chinchwad municipal corporation area of Maharashtra, India","volume":"69","author":"Sahasrabudhe","year":"2022","journal-title":"Indian J Tuberc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1002\/hpm.3151","article-title":"\u2018We are not aware of notification of tuberculosis\u2019: a mixed-methods study among private practitioners from western India","volume":"36","author":"Rupani","year":"2021","journal-title":"Int J Health Plann Manag"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.ijtb.2020.01.004","article-title":"Awareness & utilization of NIKSHAY and perceived barriers for tuberculosis case notification among the private practitioners in Udupi district, Karnataka","volume":"67","author":"Dey","year":"2020","journal-title":"Indian J Tuberc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"125","DOI":"10.3109\/03009734.2014.905664","article-title":"Understanding and changing human behaviour--antibiotic mainstreaming as an approach to facilitate modification of provider and consumer behaviour","volume":"119","author":"St\u00e5lsby Lundborg","year":"2014","journal-title":"Ups J Med Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0749-5978(91)90020-T","article-title":"The theory of planned behavior","volume":"50","author":"Ajzen","year":"1991","journal-title":"Orgnizational Behav Hum Decis Process"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criterio for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus group","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0123286","article-title":"\u201cThey know, they agree, but they don\u2019t do\u201d - the paradox of tuberculosis case notification by private practitioners in Alappuzha district, Kerala, India","volume":"10","author":"Philip","year":"2015","journal-title":"PLoS One"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-016-1943-z","article-title":"Mandatory TB notification in Mysore city, India: have we heard the private practitioner\u2019s plea?","volume":"17","author":"Singh Chadha","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e023910","DOI":"10.1136\/bmjopen-2018-023910","article-title":"Tuberculosis notification in a private tertiary care teaching hospital in South India: a mixed-methods study","volume":"9","author":"Siddaiah","year":"2019","journal-title":"BMJ Open"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.ijtb.2018.02.002","article-title":"Management practices of tuberculosis in children among pediatric practitioners in Mangalore, South India","volume":"65","author":"Sahana","year":"2018","journal-title":"Indian J Tuberc"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1093\/heapol\/czac062","article-title":"What are the tuberculosis care practices of informal healthcare providers? 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