putting the ‘community’ back into community tb management ......this poster was developed by the...

Putting the ‘community’ back into community TB management: Engaging communities to strengthen capacities to act on TB symptoms in South Africa

Session: Community engagement in finding missing casesIna Cillie and Zamani Dlamini - University Research Co., LLC, InaC@urc-sa.com & ZamaniD@urc-sa.com

Background and challenges to implementation

Enhancing community tuberculosis (TB) management contributes to improving low patient diagnosis, high loss tofollow-up and low adherence rates. The USAID Tuberculosis South Africa Project implemented a CommunityDialogue Model in 2018 and 2019 in the peri-urban districts of uMkhanyakude, KwaZulu-Natal province andWest Coast,Western Cape province, South Africa.

Implementation

Community capacity building, dialogue and health education through TB survivors and champions, andpartnerships with radio stations were utilised to incrementally increase public awareness about TB. Stakeholdersincluded traditional, religious and political leaders, traditional health practitioners, educators, communitycaregivers, healthcare workers, hospital management and media practitioners.

Acknowledgements: United States Agency for International Development (USAID) and KwaZulu-Natal and Western Cape Provincial Departments of HealthThis poster was developed by the USAID Tuberculosis South Africa Project and is made possible by the generous support of the American people through the United States Agency for International Development (USAID).

Presented at the 50th Union World Conference on Lung Health - Hyderabad, India – 31 Oct to 2 Nov 2019

Results

In uMkhanyakude, 243 people were trained through four workshops. 1,451 people were reachedthrough two campaigns, 763 with presumptive TB were tested on the spot in five communities,five were diagnosed, and two initiated on treatment. Traditional health practitioners referredtwo of those diagnosed. In all communities, people who declined to be screened or tested werereferred to clinics.

Conclusion

Monthly community radio interviews to disseminate TB information reached 130,000 people viaMtuba Rise FM in uMkhanyakude and 74,000 via Namakwaland Radio in West Coast. Socialmedia platforms were also used to generate conversations among 114,166 followers about themodel to further enhance public awareness of TB.

uMkhanyakude, KwaZulu-Natal Province

In uMkhanyakude, public healthcare facility headcounts increased and a 17.4% increase was recorded in TB screening over 12 months. This suggests that the initiativecontributed to more informed clients accessing services.

In West Coast, while public healthcare facility headcounts decreased, presumptive clients tested increased by 8.7% and the positivity rate by 8.2%, suggesting qualityscreening and that more people with TB accessed services. Educating communities about TB services supports identification of people with TB.

973

102 71 8 8

PeopleScreened

PeoplePresumptive

PeopleTested

PeopleDiagnosedwith TB

PeopleInitiated onTreatment

TB cascade results from West Coast community dialogues

1451

763 763

5 2

PeopleScreened

PeoplePresumptive

PeopleTested

PeopleDiagnosedwith TB

PeopleInitiated onTreatment

TB cascade results from uMkhanyakude community dialogues

In West Coast, capacities of 105 stakeholders to provide TB education, identify symptoms andrefer to healthcare facilities were enhanced through three workshops. Four dialogues in threecommunities reached 120 people. Door-to-door education and screening campaigns reached937 people directly. 102 people with presumptive TB were identified, 71 were tested, eighttested positive and were initiated on treatment in collaboration with TB clinics.

West Coast, Western Cape Province