Table 1 Models of care, populations served and types of services of four international NGOs involved in community based TB care in Myanmar, 2013-14
INGOs | (A) | (B) | (C) | (D) |
|---|---|---|---|---|
Model of health care delivery | Newly recruited community health volunteers (TB + HIV) | Existing community health volunteers (CHV) (TB+ malaria) | Newly recruited community health volunteers with diagnostic facilities | Established self help groups (SHG) with TB patients, family of TB patients and other community volunteers |
Model description | From village-based mobility working groups, outreach workers were identified, recruited and trained for CBTBC | Existing CHVs were used for delivery of CBTBC | • Established TB screening clinics and mobile teams to detect and diagnose TB. • DOT providers were recruited and trained to detect TB suspects and follow patients | Self Help Groups were formed and trained with the intention of delivering CBTBC with their own fund through livelihood activities |
Target population | Migrants and mobile populations | Rural heard-to-reach population | Rural population including IDPa | Urban slums |
Population size | 1 434 500 | 726 500 | 869 750 | 1 432 470 |
Volunteer payment | Salary | Travel, meals, and accommodation and costs to accompany patients for diagnostic and follow up visits | Performance- based payment based on number of TB patients referred and treated | SHGs got benefit from their livelihood activities |
Average number of volunteers per year | 117 | 796 | 436 | 157 |
Detection of TB suspects and referral | • Health education in community and migrant settings to detect TB suspects and refer them to township health departments for diagnosis. • Active TB case finding by mobile team • Contact tracing among household members | • CHVs refer people with TB symptoms to township health departments for diagnosis. • Contact tracing among household members | • DOT providers detect TB suspects in their community and refer them to INGO’s primary health care clinic and TB clinics for diagnosis • Diagnosed TB cases referred to township health department for TB treatment. • Contact tracing among household members | • Health education in community and migrant’s worksites to detect TB suspects and refer them to township health departments for diagnosis. • Contact tracing among household members |
Provision of DOTS | • Outreach Health Workers (OHWs)deliver anti-TB medicines to patients monthly • OHWs provide DOTS during the first week of treatment | • Outreach Health Workers (OHWs)supply anti-TB medicines to patients monthly • OHWs provide DOTS during the first week of treatment | • DOT providers supply anti-TB medicines to patients monthly • DOTS provided to most patients until the end of treatment | • Self-help groups supply anti-TB medicines to patients monthly DOT provided during the first week of treatment. • DOT provided until the end of treatment in selected areas |
Treatment monitoring | Monthly | Monthly | Monthly | Monthly |
Patient support | • Food • Transport fees • Costs for investigations • Meal allowance during outpatient and inpatient visits • Side effect medications | • Food • Transport fees • Costs for investigations • Meal allowance during outpatient and inpatient visits | • Food • Transport fees • Costs for investigations • Meal allowance during outpatient and inpatients visit • Side effect medications | • Food • Transport fees • Costs for investigations • Meal allowance during outpatient and inpatient visits • Side effect medications |
Health education | • Individual discussion with patients • Group health talks • Health education through FM radio | • Individual discussion with patients | • Individual discussion with patients • Group health talks | • Individual discussion with patients • Group health talks • Behavior change communication activities within community |