In Malawi, tuberculosis (TB) is a major cause of disease and death, especially among people living with HIV/AIDS. Project HOPE initiated a five-year project in 2006 in the Mulanje and Phalombe Districts to support the National TB Program and improve TB case management and treatment outcomes. We work at the health facility and community level to increase knowledge about TB, to ensure that people with TB get into treatment as soon as possible and to reduce stigma associated with TB and HIV. Our program includes:
- Training Health Care Workers
- Improving Quality of Laboratory Network
- Mobilizing the Community
The community is an essential partner in increasing the detection of TB cases and we are building knowledge about TB through community education sessions, drama and dance performances and orientations for community leaders, traditional healers and shop keepers. Themes of the education sessions include important information on TB symptoms, diagnosis and treatment as well as details on the free testing and treatment services available.
We are also training and supporting community volunteers to help detect people who have TB symptoms in their communities and to work with them to provide counseling and coordinate testing and results. These volunteers also make regular trips, on foot, to TB Microscopy centers miles away from their villages to carry TB test samples (Read a community volunteer story.)
The results have been inspiring:
- TB treatment success rate in the Mulanje and Phalombe districts has increased from 60% in to 86% during the five year period.
- Case fatality rate has decreased from 20% to 11% during the same time period
Microscopy services in the two districts:
- Increased from four sites to 10
10 Health Surveillance Assistants have been trained as microscopists
Community Sputum Collection Sites (60) have increased access to TB diagnosis
Community involvement has grown:
- More than 63,000 community members have attended health education sessions on TB
- More than 800 traditional healers and shop owners have been oriented and mentored
- More than 400 volunteers have been trained and mentored
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