Pratigya Sharma | Public Health Professional

The Problem: A Critical Blind Spot in Public Health

This story began with a critical public health challenge in my home district of Lalitpur, Nepal. The National Tuberculosis (TB) Program had a strong system, but it was missing a huge piece of the puzzle. Many people with TB symptoms first visit their local private pharmacies, doctors, and clinics—not government health centers.

This created a massive blind spot. Cases diagnosed in the private sector were often not reported to the national system. This meant official data didn't show the true scale of the TB burden, and patients could miss out on the standardized care they needed.

For the national program, the private healthcare sector was a black box. My role was created to solve this: to implement the Public-Private Mix (PPM) interventions that would bring these private providers into the national effort.

The Challenge: Building a Network from the Ground Up

As the PPM Mobilizer, my responsibility was to coordinate and maintain key programmatic partnerships. This was a complex, on-the-ground challenge that required more than just a simple directive.

Building Trust: The foundation of the PPM program was relationships. I had to build trust with dozens of independent doctors and pharmacists, showing them the value of collaborating with the national program.
Fragmented Systems: Most providers used their own paper-based records. A core part of my job was to introduce a standardized process for data collection to ensure consistency and accuracy.
Timely Monitoring: To be effective, the program required constant attention. I was responsible for the timely implementation and monitoring of all PPM activities, which involved regular site visits to provide support, collect data, and ensure protocols were being followed.

My core challenge was to create a single, reliable system out of many separate parts, ensuring that no TB patient was left behind.

The Vision: A Unified Front Against TB

The vision behind the PPM program was to create a collaborative community. Instead of seeing private providers as separate from the system, we wanted them to feel like valued partners in the national fight against TB.

This vision was simple but powerful:

Every private clinic and pharmacy would become a gateway to the national TB program.
Data from the private sector would be used to make smarter, faster decisions.
The quality of TB care would be consistent and high, no matter where a patient was diagnosed.

This strategy required dedicated, hands-on implementation to turn the vision into a reality.

The Solution: A Framework for Partnership and Monitoring

To achieve our goal, I implemented a multi-layered operational framework focused on partnership and data. Here’s how it worked:

1. A Systematic Data Collection Pipeline

I established a clear, step-by-step pipeline for data management:

Provider Training → Standardized Reporting → Regular Site Visits → Data Verification → Monthly Analysis & Reporting

This process ensured a reliable flow of information from the field to the central program, allowing for effective, data-driven decision-making.

2. Targeted Training and Support

National TB guidelines can be complex. I developed simplified training materials and provided one-on-one coaching during my site visits. This hands-on support was crucial for maintaining strong programmatic partnerships and ensuring providers felt confident in their role.

3. A Collaborative Monitoring & Evaluation (M&E) Framework

Data is only useful if it leads to action. A key part of my role was reviewing the data I collected to identify performance gaps and recommend solutions.

Ground-Level Data → Monthly Reports → Joint Review with Partners (NTCC, Save the Children) → Identify Gaps → Recommend Interventions

My recommendations, based on this field-level data, directly contributed to strengthening the program's overall M&E system and improving care delivery in Lalitpur.

4. The Architecture of Partnership

My position at Nepal CRS Company, a pioneer social marketing organization, was central to this effort. I acted as the crucial link between the government's National Tuberculosis Control Centre (NTCC) and the hundreds of individual private providers. By working alongside partners like Save the Children, we built a resilient and collaborative network that significantly increased the reach and effectiveness of Nepal’s TB program.