Advocacy, Communication and Social Mobilization for TB Control in Kenya
Stopping TB through social mobilization and community partnerships
23
Our vision for every child, life in all its fullness, Our prayer for every heart, the will to make it so. Stopping TB through social mobilization and community partnerships Adhi Sanjaya Adhi Sanjaya Milton Amayun Milton Amayun Sri Chander Sri Chander Presented in Presented in 34 34 th th Annual International Conference on Global Annual International Conference on Global Health and CCIH 2007 Annual Conference Health and CCIH 2007 Annual Conference Lessons learned from FIGHT Project
description
Stopping TB through social mobilization and community partnerships. Lessons learned from FIGHT Project. Adhi Sanjaya Milton Amayun Sri Chander. Presented in 34 th Annual International Conference on Global Health and CCIH 2007 Annual Conference. REPUBLIC OF INDONESIA. EAST FLORES. - PowerPoint PPT Presentation
Transcript of Stopping TB through social mobilization and community partnerships
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
Stopping TB through social mobilization and community
partnerships
Stopping TB through social mobilization and community
partnerships
Adhi SanjayaAdhi Sanjaya
Milton AmayunMilton Amayun
Sri ChanderSri Chander
Presented in Presented in
3434thth Annual International Conference on Global Health Annual International Conference on Global Health and CCIH 2007 Annual Conferenceand CCIH 2007 Annual Conference
Lessons learned from FIGHT Project Lessons learned from FIGHT Project
REPUBLIC OF INDONESIAREPUBLIC OF INDONESIA
MANGGARAI
EAST SUMBAKUPANG DISTRICT
BELU
NGADA
WEST SUMBA
ALOR
ENDE SIKKA
TIMOR TENGAH SELATAN (TTS)
LEMBATA
EAST FLORES
TIMOR TENGAH UTARA (TTU)
ROTE NDAO
KUPANG CITY
SABU ISLAND
MAP OF NTT PROVINCE 2004MAP OF NTT PROVINCE 2004
Islands 566; 43 inhabited
Population 4,165,568 (2004 census)
Land / sea ratio 1 : 4.2
Administrative 15 districts + 1 municipality
"municipality" does not show up on slideWhat is meant by "Land/sea"?Change "Administrative" to "Administration"
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
4
NTP in NTT (2000)NTP in NTT (2000)
Low Case Detection Rate Low Cure Rate Less coverage of DOTS service Poorly trained health staff in NTP High ratio of population per health staff Weak collaboration between HCs (DOTS
provider) and hospitals or private health provider
Low level of community involvement in health programs.
Is it clear what NTP and NTT mean?Is "capacity" the right word in #4?
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
5
FIGHT ProjectFIGHT Project
Food integrated to hinder tuberculosis.Funded by CIDA, March 2000 – Sept 2006.Covers 5 districts, total population 1.1 M. As a partner of government’s NTP.Goal: “To contribute to the decrease of TB mortality and morbidity among people of NTT province”.Work focus: district level.
Re-word #1 "Food integrated to hinder..."Format number in #3#4: Remove word "as"?#6: "Focusing" to "Focuses"?
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
6
FIGHT Outcome ObjectivesFIGHT Outcome Objectives
Improved and sustained quality DOTS TB program management Increased participation and commitment of district government and TB DOTS implementers in TB control program Enhanced community participation in improving a sustainable community-based TB control program
Make sure verbs all agree in tense
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
7
DOTS and FIGHT approachesDOTS and FIGHT approaches
Political commitment with increased and sustained financingCase detection through sputum smear microscopy examinationStandardized treatment with supervision and patient supportAn effective drug supply and management system.M&E system and measurement
DOTS implementation.Capacity building for health staff Community knowledge, skill and behaviorMonitoring, supervision and evaluationNetworking and advocacyResources mobilizationFood aid component (discontinued since April 05)Micronutrient research
*Last comment on left not on slide*Remove periods at end of bullet points?
Assisted areas 2000 to 2006Assisted areas 2000 to 2006
Districts2000 2006
HCs Population HCs Population
Alor Dist 5 74,220 9 109,647
Kupang City 2 74,543 6 226,890
Kupang Dist 3 59,104 9 149,801
Rote Ndao 2 46,889 4 69,554
TTU Dist 4 69,581 12 175,345
Total 16 324,337 40 731,237
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
9
Changes in district TB budget (US$)Changes in district TB budget (US$)
Districts Year 2006 Year 2007 %
Alor District N/A 830.83 +
Kupang City 144.44 462.67 220.3%
Kupang District
5,395.56 8,050.00 49.2%
Rote Ndao 277.78 611.11 119.9%
TTU District 1,666.67 2,777.78 66.7%
TOTAL 7,484.45 12,732.39 70.1%
Percent increase is inaccurate. Change to read: "Percent of 2006 budget" or change calculationsChange heading from "Year 2006" to "2006 Budget"
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
10
Case Notification Rate (xx/100,000)Case Notification Rate (xx/100,000)
0
20
40
60
80
100
120
2000 2001 2002 2003 2004 2005 2006
FIGHT NON FIGHT WHO AusAID TOTAL NTT Post WHO AusAID
What does xx/100,000 mean?Label axes
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
11
Sm+ cases detected (total 2,859)Sm+ cases detected (total 2,859)
166
377 385
566
287
489
346
512426
648 678
854
737
9831104
0
200
400
600
800
1000
1200
2000 2001 2002 2003 2004 2005 2006(Sept)
2006
Do you mean 2.859 milliion; 2,859, or something else?Label x- and y- axes
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
12
A TB patient’s profile:A TB patient’s profile: Mostly poor Low educated – did not
finish elementary school Low nutrition intake
(only 922.4 Kcal / day) Self medicates first with
traditional medicine Knows the disease can
kill – but doesn’t know the treatment is FREE
Slow to seek health services (12 weeks delay from the first symptom)
Change "low educated" to "poorly educated" or "low education"Change "low nutrition intake" to "insufficient nutrition intake"??? (Remove "only")Spell out "calories" in #3?Change #4?Change #5 verbs to make them agreeRemove "for" in #6-Also, change "12 weeks delay" to "12-week average delay"
Dist Chief/LGU/Planning Dept
HCs / Private Clinics
NGOs, CBOs, FBOs, etc.
Village Leadership
Community/Self-Help Groups
TB patient & family
13
Health Center
Mobile HC
Village Midwive
s
Sub HC
Health Center
Government officers
Church
Self-help groups
Traditional leader
Health Cadres
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
16
NTT Governor Piet A. Tallo, is giving Category 1 TB drugs to a TB patient treated in Prof. Dr. W. Z. Johannes Provincial Hospital in Kupang, symbolizing the launching of Johannes DOTS Center on the National Health Day 12 November 2005.
Remove comma after governor, change "Governor" to "governor"?Remove "is" and "treated"Change "DR." to "Dr."RE-WORD
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
17
Some lessons learned from the fieldSome lessons learned from the field
Show them that you care! Benefits of home visits for treatment compliance and supervision – also for contact tracing.
Stress your rules! Patient signs letter of agreement to comply with the treatment regimen
Give testimonies!Give testimonies! The most effective The most effective promotion is the promotion is the one given by ex-TB one given by ex-TB patientpatient
Involve other parties Obtain religious
institutional support in TB treatment and case detection.
Invest in TB prevention in schools as public health investment for the future.
Be creative and eye-catching.
Audio visual promotion method more appealing to community.
Change "institution" to "institutional"?
Our vision for every child, life in all its fullness,Our prayer for every heart, the will to make it so.
19
Using TB patient’s photos (by permission) as advocacy tool.
Identifying influential Identifying influential leaders leaders to help to help mobilize community mobilize community and to improve and to improve participation. participation.
"Identifying influential leaders to help mobilize community and gather more participation."
Don’t be afraid to change!Open and intensive communication anticipate reaction to an unpopular decision. (eg. discontinuing the food aid and incentives).
Inappropriate knowledge about the disease stigmas hinders case finding, treatment and patient’s monitoring activity.
Change "hinder" to "hindered"*Format to make sure #3 fits*
Ms. Esther Tabusan, 18 y.o.
Before
After
Write out "years old"
Mr. Urfinus Sa’u, 53 yo
At the beginningAnd 7 months later…
Write out "years old"Add ellipses (...) to end of "At the beginning" and beginning (not end) of "And 7 months later"
