Community-Based TB Care: Experience from ... - CORE Group

Community Based TB care through former TB patients’ social clubsEffectiveness of community-based directly observed treatment for tuberculosis in anurban setting in Tanzania revealed in 2004 through a randomised controlled trialconducted in Temeke district. The Objective of the study was to evaluate theeffectiveness of community-based direct observation of treatment (DOT) usingguardians and former TB patients compared to hospital-based DOT in an urbansetting in Tanzania. Both DOT options gave similar treatment outcomes. It concludedthat Community-based DOT is as effective as health facility-based DOT and canachieve good treatment outcomes (Wandwalo et al, 2004).Another study conducted in the same district in 2005 to determine the and costeffectiveness of health facility and community based TB DOTS in an urban setting inTanzania revealed that, the total cost of treating a patient with conventional healthfacility based DOT and community based DOT were $ 145 and $ 94 respectively.Cost fell by 27% for health services and 72% for patients. Indirect costs were asimportant as direct costs, contributing to about 49% of the total patient's cost. Themain reason for reduced cost was less number of visits to the TB clinic. Communitybased DOT was more cost-effective at $ 128 per patient successfully treatedcompared to $ 203 for a patient successfully treated with health facility based DOT(Wandwalo et al, 2005).It is envisaged that when such initiatives are well documented, they will form thebasis for scaling up the approaches to cover the whole country in future. In order toachieve the goal, the NTLP seeks to hire a consultant who will develop thedocument.2.0 Objectives of the proposed assignmentThe objective of the proposed assignment is to document community based-care practices inTemeke district.3.0 Scope of work3.1 In documentation process, the team will carry out the following tasks:a) Visit MUKIKUTE office and Selected TB clinics in Temeke with the particularattention of:• Interviewing the administration of the organization, the health workersworking in TB clinics in Temeke and the community.• Go through the important documents of MKIKUTE such as constitutions,reports, etc• Identify the best community based care practicesb) Document the best practices on MUKIKUTE and Temeke TB clinicc) Prepare a document and submit it to the Programme Manager of NTLP.3.2 Format of the Document• Cover page• Table of contentsExperience from Temeke Page 19