Table 5 Organizational transition in Shanghai Changning and Guangxi Nanning

In SC, there was an independent TB dispensary directly affiliated to the health bureau before 1995. However, the development of TB dispensary was challenged by the diminished government funding. In 1995 a chronic Disease Control Institute was established and TB dispensary was merged into this institute. In 2000, following the national health sector reform the CDC was set up and the chronic disease control station was merged into the CDC. In 2007, the CDC was moved into a new public health building, where conducting TB clinical activities seemed no longer appropriate. By that time, most of the other districts in Shanghai had adopted the integrated model. At the request of the health bureau, a district general hospital was designated to provide TB service.

In GN, early in 1996, TB clinical service was co-provided by an independent TB dispensary, a prefectural general hospital, a medical university affiliated hospital, a provincial hospital. However, it was recognized that the complexity of TB service delivery structure had resulted in the poor coordination and management of TB care. In 2002, the prefecture CDC was established following the national reform, incorporating the anti-epidemic station, health education institute and the TB dispensary. In 2005, the prefectural general hospital was designated to fully provide the TB service, and all the TB cases/suspects were required to be referred to this hospital for standardized treatment and management.