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International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014
BACKGROUND: National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364576/ https://www.ncbi.nlm.nih.gov/pubmed/28335830 http://dx.doi.org/10.1186/s40249-017-0285-3 |
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author | Soe, Kyaw Thu Saw, Saw van Griensven, Johan Zhou, Shuisen Win, Le Chinnakali, Palanivel Shah, Safieh Mon, Myo Myo Aung, Si Thu |
author_facet | Soe, Kyaw Thu Saw, Saw van Griensven, Johan Zhou, Shuisen Win, Le Chinnakali, Palanivel Shah, Safieh Mon, Myo Myo Aung, Si Thu |
author_sort | Soe, Kyaw Thu |
collection | PubMed |
description | BACKGROUND: National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. METHODS: We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013–2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. RESULTS: All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15–52%). CONCLUSION: Community-based TB care supported by INGOs successfully achieved TB case detection in hard-to-reach and vulnerable populations. This is vital to achieving the World Health Organization End TB Strategy targets. Strategies to ensure sustainability of the programs should be explored, including the need for longer-term commitment of INGOs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0285-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5364576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53645762017-03-24 International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 Soe, Kyaw Thu Saw, Saw van Griensven, Johan Zhou, Shuisen Win, Le Chinnakali, Palanivel Shah, Safieh Mon, Myo Myo Aung, Si Thu Infect Dis Poverty Research Article BACKGROUND: National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. METHODS: We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013–2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. RESULTS: All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15–52%). CONCLUSION: Community-based TB care supported by INGOs successfully achieved TB case detection in hard-to-reach and vulnerable populations. This is vital to achieving the World Health Organization End TB Strategy targets. Strategies to ensure sustainability of the programs should be explored, including the need for longer-term commitment of INGOs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40249-017-0285-3) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-24 /pmc/articles/PMC5364576/ /pubmed/28335830 http://dx.doi.org/10.1186/s40249-017-0285-3 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Soe, Kyaw Thu Saw, Saw van Griensven, Johan Zhou, Shuisen Win, Le Chinnakali, Palanivel Shah, Safieh Mon, Myo Myo Aung, Si Thu International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 |
title | International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 |
title_full | International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 |
title_fullStr | International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 |
title_full_unstemmed | International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 |
title_short | International non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013–2014 |
title_sort | international non-governmental organizations’ provision of community-based tuberculosis care for hard-to-reach populations in myanmar, 2013–2014 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5364576/ https://www.ncbi.nlm.nih.gov/pubmed/28335830 http://dx.doi.org/10.1186/s40249-017-0285-3 |
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