Community involvement in tuberculosis control lessons from other health care programmes

A specific diagnostic test for tuberculosis (TB) has been available since 1882 and drug treatment since 1942, but still the problem of TB persists. In developing countries the disease is accountable for 25% of avoidable deaths.2 The reasons behind this are a complex combination of biological, social and political factors that influence the progress of this epidemic and control efforts. Decentralising TB control measures beyondhealth facilities, by harnessing the contribution of community organisations, has the potential to increase access to effective treatment. Community involvement in health care has been widespread. Harnessing community contribution to TB control needs to take heed of the lessons learnt from such experiences. The purpose of this paper is to give examples of the lessons for community involvement in TB control learned from other health care programmes.

To take full advantage of the varied experiences of other programmes, specific aspects of TB control are discussed in the paper. For each aspect examples are given of the successful approaches from other areas of health care that may address constraints to TB control. There are examples of formal and informal community involvement. Formal involvement refers to the use of community members chosen to play a part withinthe infrastructure of the health services, such as community health workers (CHWs), village health workers (VHWs) and traditional birth attendants (TBAs). Informal involvement includes the participation of neighbours, family members and other community members in the support of one or more patients. The final section reviews general lessons learnt from the extensive experience of CHW programmes in the 1980s and 1990s. These lessons will provide a solid basis on which to launch community-based TB control programmes.

The aspects of TB control discussed in this paper are awareness raising, case finding, providing access to treatment, addressing stigma, supporting patients during treatment, record keeping and tracing those who interrupt treatment.

 Referensi :

Hadley, M., and D. Maher. "Community involvement in tuberculosis control: lessons from other health care programmes." The International Journal of Tuberculosis and Lung Disease 4.5 (2000): 401-408

Ruminah

Kebijakan dan Manajemen Pelayanan Kesehatan

Universitas Gadjah Mada