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Dr. Giuliano Gargioni, WHO/HQ, Stop TB Department

A Planning Framework for Community Involvement Stop TB Workshop on TB Proposal Preparation for GFATM Round 6 15 – 18 May 2006. Dr. Giuliano Gargioni, WHO/HQ, Stop TB Department. The STOP TB Strategy. Component 5: Empower people with TB and communities. What is Community TB Care (CTBC).

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Dr. Giuliano Gargioni, WHO/HQ, Stop TB Department

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  1. A Planning Frameworkfor Community InvolvementStop TB Workshopon TB Proposal Preparationfor GFATM Round 615 – 18 May 2006 Dr. Giuliano Gargioni, WHO/HQ, Stop TB Department

  2. The STOP TB Strategy Component 5: Empower people with TB and communities

  3. What is Community TB Care (CTBC) Operational partnership between the health services and civil society aimed at contributing to TB control. Responsibility for TB control remains with the NTP. Goal: To promote and to improve the general health status of the population through TB case detection and treatment success by involving motivated people at community level in raising public awareness about TB and in provision of care and support to patients.

  4. To improve geographic and economic access to TB diagnosis and treatment To improve case detection (referral of persons with chronic cough) To provide support to patients throughout treatment until cure To empower patient, family and community through education To enhance treatment adherence To advocate for political commitment to TB control Objectives of CTBC:

  5. Rationale for CTBC initiatives Concentration of Dx and Tx health facilities in and around urban settings with poor accessibility (geographic and economic) for rural based population.Hospitalization (but also mere daily attendance) of TB patients, often unnecessary, is costly for Health Services and imposes a further direct and indirect costs on patients and their families.This prevents TB patients from attending regular follow-up visits at clinics when discharged from the hospital.As a result, many TB patients are not cured and the disease spreads to other people.CTBC addresses these constraints to improve pt's support/care.

  6. CTBC and Health System strengthening • From a mere "disease control" paradigm to health promotion and prevention • Promote capacity for community participation in other essential health interventions • Reduced workload and congestion of health facilities: more resources available for pts in need of more intensive care and for other services • Empowerment and co-responsibility enhance accountability to the population served, but also appreciation for work of health staff and sustainability of services • Completeness and accuracy of M&E data

  7. 1. Preparations i) conduct situation analysis; advocate with political leaders and discuss with health authorities the involvement of community in TB control; Involve communities in designing model of participation develop national operational guidelines and IEC material, based on i) and iii). 2. Facilitate meeting with relevant district authorities Service Delivery Areas and Activities

  8. 3. Training for community involvement i) develop and produce training material for health staff based on national guidelines; ii) develop and produce training material for community participants; iii) conduct training of health staff; iv) sensitize relevant community members on nature and extent of TB, in order to motivate them to share responsibility on health matters, (avoid mere decentralization of services into the community); v) sensitize and train relevant community members. Service Delivery Areas and Activitiescontd

  9. 4. Delivery of TB services through community involvement establish referral/communication system between health facility and community (public health staff or CHWs, NGOs or FBOs). Establish regular contact with all community members involved, ensure regular support, drug supply, and develop and disseminate M&E docs which include care provider contact info, referral sheets for use by community members, etc. If the DHS adopt this approach, the district budget for health should include all elements (logistics, perdiems, etc) required to support and ensure continuity of work at community level. Service Delivery Areas and Activitiescontd

  10. 5. ACSM activities on TB and community involvement i) inform general population about TB, availability of diagnosis, treatment and care at community level. Include TB messages into general health promotion material and initiatives. ii) propose proactively to other health care providers to establish an appropriate collaboration with communities, directly or through other providers who are closer to where people live and work. Service Delivery Areas and Activitiescontd

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