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FROM THE FIELD

Recognizing World TB Day 2009
24 Mar 2009 19:38:00 GMT
 Source: Project HOPE - USA
Website: Website: http://www.projecthope.org

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A healthcare worker in Kazakhstan learns new microscopy skills in TB detection.
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A healthcare worker in Kazakhstan learns new microscopy skills in TB detection.
Project HOPE

Background

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Project HOPE began working to fight tuberculosis (TB) disease in Kazakhstan in 1993, piloting early DOTS programs, which are the current international standards for TB control. In the 1990s, the break up of the Soviet Union led to serious deterioration in the health systems in Central Asian Republics (CAR), leading to poor health outcomes and drastic increases in the number of reported TB cases.

By 2001, Project HOPE was working with TB programs in all five CAR countries (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan) and is currently implementing the largest and most comprehensive TB program in the region. By training health providers on DOTS, improving TB case management through monitoring and supportive supervision, strengthening the laboratory network and conducting community education and mobilization activities, Project HOPE has worked with the CAR countries to improve TB control.

Here are some of our program strategy successes:

Training, Monitoring & Supportive Supervision Project HOPE trains TB specialists, primary care doctors, nurses and laboratory workers in TB control, using the DOTS strategy. A key component of the training is follow up monitoring and supportive supervision, which offers a positive method of ensuring correct use of new skills through supportive follow up and on-the-job training. This approach replaced a punitive approach to supervision and has been well received and has helped reduce doubt about DOTS. To make this sustainable, country staff is trained to conduct monitoring and supportive supervision. Work has been done on updating training curricula and standardizing monitoring checklists.

Improving Laboratory Quality

Project HOPE has worked to improve quality in laboratories in all five CAR countries by: • promoting microscopy as the primary means for diagnosis • equipping laboratories with microscopes and consumable materials • training staff in conducting sputum smear microscopy, training both lab technicians and trainers in conducting sputum smear microscopy, in basic and advanced methods • conducting routine monitoring visits • creating checklists • developing guidelines and revised standards • introducing an external quality assurance system for smear microscopy in pilot sites (View the Poster at www.projecthope.org) • building the capacity of National Reference Laboratories and assisting them with certification

Increasing Awareness of TB in the Community

Project HOPE is increasing awareness of TB in the community through a variety of strategies, including mass media, IEC/BCC approaches, focused trainings, and a small grants program to increase involvement of local NGOs in increasing TB awareness and decreasing stigma. Examples include:

• Interpersonal Communication skills training for health providers to improve patient communication and reduce stigma • Communication training for nurses on patient counseling, using a flip book to increase patient knowledge about TB and the importance of treatment adherence • Training for journalists on how to correctly report on TB • Regional training on development and adaption of IEC materials • Training volunteers to run Treatment Support Groups • Training staff from Healthy Lifestyle Centers to provide education and outreach in health facilities and communities • Developing Public Service Announcements (View a PSA from Uzbekistan at www.projecthope.org) • Small grant for theater performances and puppet shows on TB. In one grant, the performances were led by a professional team of actors, key messages on TB were incorporated into the performance. A local doctor was present to provide information on available facilities. The performance was recorded and distributed to other community organizations, and a radio broadcast version is ongoing.

Selected Program Results

Project HOPE has been working in close collaboration with the National TB Programs in CAR to help them improve their capacity to fight TB disease. These efforts have lead to detecting more TB cases, better treatment success, less death due to TB disease, and a reduction in the burden of TB in the population of each country.

• More than 11,000 health care workers and community volunteers have been trained to date through this project, including TB physicians, primary care physicians, laboratory specialists, nurses, monitoring specialists and others. • Project HOPE's activities for raising community awareness on TB have been singled out by WHO to be published as best practices. • In Tajikistan, Project HOPE strengthened national capacity for microscopy and facilitated the first seminars on culture diagnostics and drug sensitivity. • In Kazakhstan, Project HOPE implemented external quality assurance for microscopic laboratories in the Almaty region that can be adopted for use at the national level.

Multiple operational research studies have been conducted in collaboration with National TB Programs and thematic working groups including reasons for TB patient default, rational drug use, adverse reactions to first-line TB drugs and TB among migrants. Results of these studies have been shared with national and international organizations working in TB and the data is used to adjust program activities to address the issues found in the studies to strengthen the TB programs. Several publications, including case studies and operations research results, have been published in international journals and these and other program activities have been presented at the Annual International Union Against Tuberculosis and Lung Diseases (IUATLD) Conference in Paris and other conferences

To view the publications(visit our Web site at www.Projecthope.org)

Default from tuberculosis treatment in Tashkent, Uzbekistan; Who are these defaulters and why do they default?

Using Incentives to Improve Tuberculosis Treatment Results: Lessons from Tajikistan

Health-care seeking behavior for TB symptoms in two provinces of Uzbekistan


[ Any views expressed in this article are those of the writer and not of Reuters. ]

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[ Any views expressed in this article are those of the writer and not of Reuters. ]

Background information

Topics
Health
Facts & figures
Kazakhstan Kyrgyzstan Tajikistan Turkmenistan Uzbekistan

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Last updated:Tue Mar 24 19:46:44 2009