USAID Empowers Communities as Partners in Local TB Control

Using a flipchart on basic TB-DOTS produced with USAID support, trained community volunteers educate communities and correct long-held myths and misconceptions on tuberculosis, its cause, transmission, and treatment. (Photo: PBSP)

Tuberculosis (TB) used to be the 6th leading cause of death in Zamboanga Sibugay in southern Philippines. While public health personnel would have wanted to bring TB care to the communities, their geographic location, poor roads, the unavailability of transportation, prohibitive fare, as well as related direct and opportunity costs undermined this good intention.

By training over 1,000 parish volunteers of the Catholic church’s Community-based Health Program (CBHP) on basic TB and DOTS (Directly Observed Treatment, Short Course), USAID helped improve TB control in the province. Trained volunteers educated their barangays (villages) on TB; corrected long-held myths and misconceptions on the disease, its transmission, and treatment; and promoted healthy behavior. Subsequently, the volunteers identified community members with symptoms of TB and referred them to the nearest health center. Majority (78%) of those they referred submitted for TB diagnosis. As treatment partners, the volunteers directly supervised patients as they took their daily anti-TB drug medication. They monitored each patient’s schedule of follow-up sputum examination, ensuring that patients underwent the follow-up test that will confirm if they are free of the TB bacteria. Nearly all patients whose treatment was supervised by church volunteers completed the treatment and were cured.

From 2013 to 2014, the CBHP volunteers helped identify an average 84 new smear-positive (NSP) TB cases per year who otherwise would have been left untreated, further transmitting the disease to an average 110 other individuals each year. In all, the community volunteers contributed 15% to the province’s total average count of 562 NSPs.

Community volunteers who trained on basic TB-DOTS with USAID technical assistance organize community members in small groups in remote areas that public health workers are unable to reach with TB education. (Photo: PBSP)

From 2013 to 2014, the CBHP volunteers helped identify an average 84 new smear-positive (NSP) TB cases per year who otherwise would have been left untreated, further transmitting the disease to an average 1-10 other individuals each year. In all, the community volunteers contributed 15% to the province’s total average count of 562 NSPs.