Background: Public-Private Mix (PPM) strategy has been shown to be an effective approach to increasing tuberculosis (TB) case notification on a global scale. Nevertheless, this strategy continues to encounter various barriers in its implementation, including in Bangli District. Objective: This study aims to explore the participation of private health services, and the barriers in TB notification. Methods: This study employs a descriptive cross-sectional design. The respondents were TB programme officers working at public health centres (PHCs) and private services in Bangli District. Structured interviews were conducted with 12 TB program officers, while 47 private services consented to complete an e-questionnaire. The quantitative data collected was analysed descriptively. Results: A total of 74.5% of private services had become part of the network, and 88.6% of them were still committed to participating. Of all the private services that responded, 41.82% were private midwives. Most private services chose to refer suspected TB cases, rather than other role. PHCs have identified several key challenges, namely the recording and reporting tasks, financing, facilities issues, the strengthening of networks, and the identification of cases and close contact tracing. In contrast, the barriers experienced by private services primarily concern technical aspects of diagnosis and reporting forms. Conclusion: In order to enhance the involvement of private health services, it is essential to reinforce the district-based public-private partnership through the following measures: enhanced coordination and network expansion, accelerated technical training, improved basic diagnostic and referral facilities, and simplified reporting systems for private health services.
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