Role of community health workers in improving cost efficiency in an active case finding tuberculosis programme: an operational research study from rural Bihar, India

Garg, Tushar; Bhardwaj, Manish; Deo, Sarang

doi:10.1136/bmjopen-2019-036625

Cited by 17 publications

(23 citation statements)

References 39 publications

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“…Although CHW have been involved in TB community activities, their involvement in the TPT management was quite unique in the CONTACT study (37) (15).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

Vasiliù¹,

Tiendrebéogo²,

Awolu³

et al. 2021

Preprint

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BackgroundOne of the main barriers of the management of household tuberculosis child contacts is the necessity for parents to bring healthy children to the facility. We assessed the feasibility of a community intervention for tuberculosis (TB) household child contact management and the conditions for its evaluation in a cluster randomized controlled trial in Cameroon and Uganda.MethodsWe assessed three dimensions of feasibility using a mixed method approach: (1) recruitment capability using retrospective aggregated data from facility registers; (2) acceptability of the intervention using focus group discussions with TB patients and in-depth interviews with healthcare providers and community leaders; and (3) adaptation, integration and resources of the intervention in existing TB services using a survey and discussions with stakeholders.ResultsReaching the sample size is feasible in all clusters in 15 months with the condition of regrouping 2 facilities in the same cluster in Uganda due to decentralization of TB services. Community health worker (CHW) selection and training and simplified tools for contact screening, tolerability and adherence of preventive therapy were key elements for the implementation of the community intervention Healthcare providers and patients found the intervention of child contact investigations and TB preventive treatment management in the household acceptable in both countries due to its benefits (competing priorities, transport cost) as compared to facility-based management. TB stigma was present, but not a barrier for the community intervention. Visit schedule and team conduct were identified as key facilitators for the interventionConclusionsThis study shows that evaluating a community intervention for TB child contact management in a cluster randomized trials is feasible in Cameroon and Uganda.Trial registration: ClinicalTrials.gov, NCT03832023. Registered on February 6th 2019

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“…Although CHW have been involved in TB community activities, their involvement in the TPT management was quite unique in the CONTACT study (37) (15).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

Vasiliù¹,

Tiendrebéogo²,

Awolu³

et al. 2021

Preprint

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“…The project staff interfaced with the corresponding officials in the national TB program regularly. The organizational details have been described previously [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

Can Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation Research from India

Garg¹,

Panibatla²,

Carel³

et al. 2021

TropicalMed

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Navigating the Indian health system is a challenge for people with tuberculosis (TB) symptoms. The onus of organizing care is on the patient and their families alone. Factors like gender discrimination and opportunity costs further aggravate this. As a result, people may not complete the diagnostic and treatment pathway even though they experience poor health. Navigators can aid in the pathway’s completion. We implemented two projects in India—a public sector intervention in Bihar, with a population of 1.02 million, and a private sector intervention in Andhra Pradesh (AP), with a population of 8.45 million. Accredited Social Health Activists (ASHAs) of the public health system in Bihar and local field officers in AP facilitated the patients’ navigation through the health system. In Bihar, ASHAs accompanied community-identified presumptive TB patients to the nearest primary health center, assisted them through the diagnostic process, and supported the patients throughout the TB treatment. In AP, the field officers liaised with the private physicians, accompanied presumptive patients through the diagnosis, counseled and started treatment, and followed-up with the patients during the treatment. Both projects recorded case-based data for all of the patients, and used the yield and historical TB notifications to evaluate the intervention’s effect. Between July 2017 and December 2018, Bihar confirmed 1650 patients, which represented an increase of 94% in public notifications compared to the baseline. About 97% of them started treatment. During the same period in AP, private notifications increased by 147% compared to the baseline, and all 5765 patients started treatment. Patient navigators support the patients in the diagnostic and treatment pathways, and improve their health system experience. This novel approach of involving navigators in TB projects can improve the completion of the care cascade and reduce the loss to follow-up at various stages.

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“…It is hoped that the involvement of these members will make it easier for TB suspects to be examined because they are considered to be closer and more acquainted with the community than health workers. [8] From its establishment until now, the implementation of the TB community activities is still waiting for instructions from the TB program holders. There is no management in the TB community group, and the participation of members is still lacking.…”

Section: Research Backgroundmentioning

confidence: 99%

“…Its area is about 169,616.65 Ha, consisting of 24 sub-districts, 325 villages, and 33 Puskesmas. [8] The Puskesmas in the Probolinggo Regency has implemented The TB case discovery by the TB community in Puskesmas Wangkal, Kraksaan, Krejengan, Pajarakan, and Maron in the last four years from 2017 to 2020 showed that the achievement of TB case detection had not met the target set.…”

Section: The Profile Of the Tb Community In Probolinggo Regencymentioning

confidence: 99%

“…[9] [14] E3S Web of Conferences 317, 04018 (2021) ICENIS 2021 https://doi.org/10.1051/e3sconf /202131704018 For this reason, the role of community social workers in health can increase the national target for TB case detection by mobilizing the community in health services. [8] The TB community is a social worker is expected to help increase TB case detection; one of its activities is to conduct home visits to search for TB suspects. [19] In accordance with the TB control program to improve community-based health services, an important role is to investigate the home contacts of TB suspects.…”

Section: The Role Of Tb Community In Providing Counsellingmentioning

confidence: 99%

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The Role of the Tuberculosis (TB) Community in Detecting TB Suspects in Probolinggo Regency, East Java

et al. 2021

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Indonesia Indonesia is in the third rank of countries with the highest tuberculosis (TB) globally, with TB case detection still below 70%. The strategy in the TB control program to increase TB case detection is community partnership through the TB community. However, the role of this community in detecting TB suspects has never been reported. This study aimed to determine the role of the TB community in detecting TB suspects in the Probolinggo Regency. This research is descriptive qualitative research. The population was all TB community members is 130 people. The sample was a purposive sampling method, consideration until it met the data saturation, namely 29 respondents. The data were collected employing interviewed sheets, then analyzed with thematic content. Data triangulation by Head of Infectious Diseases, the Probolinggo Regency Health and five people from each TB community at Puskesmas. From the interviews, it was found that 23 people (79%) could not invite TB suspects to undergo examination, and 25 people (86%) had conducted counselling but were still unable to explain and convince the community of the importance of medical examinations for TB suspects. It is necessary to increase the capacity of TB community members to improve their roles in detecting TB cases.

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Role of community health workers in improving cost efficiency in an active case finding tuberculosis programme: an operational research study from rural Bihar, India

Cited by 17 publications

References 39 publications

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

Can Patient Navigators Help Potential TB Patients Navigate the Diagnostic and Treatment Pathways? An Implementation Research from India

The Role of the Tuberculosis (TB) Community in Detecting TB Suspects in Probolinggo Regency, East Java

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