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

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Community Based TB care through former TB patients’ social clubsDOT in Temeke municipal council. The club is implementing a lot of activities and it has shownremarkable achievements concerning community based TB care.In view of these achievements, the Ministry of Health and Social Welfare (MoHSW) throughNTLP decided to document Temeke experience, best practices and lessons learnt oncommunity based TB care and share with different stakeholders. This document will also beused as the base for development of Terms of Reference (TOR) and training package forestablishment and management of former TB patients’ clubs in other districts across thecountry.Experience from TemekePage v
Community Based TB care through former TB patients’ social clubsExecutive summaryEmpowering and involving former TB patients in improving community TB care revealed to bean effective method of increasing TB case detection rates as well as improving TB treatmentoutcome. It is clearly connected to other priorities in TB control.In regards of involving former TB patients in community based TB care, Temeke was the firstdistrict to establish and maintain a successful former TB patients’ group, as the initiative ofimplementing community based TB care (CBTC) in the district. This document presents the bestpractices of community based TB care in Temeke.Multiple strategies were used to obtain relevant information for this document. The strategiesincluded interviewing the regional TB and Leprosy Coordinator of Temeke, health workers in TBclinics and administration of MUKIKUTE (former TB patients’ organization). Available published,grey literature and reports on the empowerment and involvement of patients and former patientsin TB control were also reviewed. The interview covers the general information of theorganization, activities implemented by the organization, roles and responsibilities of members,source of funds as well as on how health workers including Regional and District TBcoordinators work with and support the group.Cured TB patients from MUKIKUTE have been working in collaboration with health workers inTemeke NTLP region. They have been involved in social mobilization, providing treatmentsupport to patients under home based DOT, shared their experience with TB patients undertreatment brought suspected cases to the TB centre and assist TB patients to correctly followtheir treatment. Norwegian Heart and Lung patients Association has been providing financialsupport, while Temeke Municipal Council provides financial and technical support.The major lessons learned include community involvement through former TB patients’ groupscreated and strengthened the sense of an individual, family and community responsibility in TBcontrol. This also empowered the ex-patients to take on an active role in the fight against TB;enhancing community awareness through the use of former TB patients as informants andtreatment supporters has contributed towards reducing default rates and improving cure rates. Ithas also contributed towards reducing stigma and discrimination of TB patients in the family andcommunity. Former TB patients’ groups hardly ever empower themselves but need theinvolvement of stakeholders other than the TB programme.The document recommends the establishment of former TB patients’ club for community TBcare with major activities of conducting sensitization gatherings and trainings; defaulter and TBcontact tracing; and supervising patients under home based DOT. Only committed former TBpatients are recommended for enrolment. A joint plan for CBTC activities between the Councilsand TB clubs is also recommended. Health workers are recommended to provide technicalassistance and a maximum cooperation for capacity building among the former TB patients fortaking up an active role in the fight against TB. TB control programme at district level advised toallocate funds, and looking for donors to support former TB patients. However, the Councilsadvised to assist clubs in establishing income generating activities for their sustainability.Experience from TemekePage vi
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