Tuesday, May 15, 2007

Replicating a successful model for combating TB

A doctor in Romania checks a client for
symptoms of TB

As HealthRight transfers control of our Tuberculosis Control Project in Romania to local partners, we are replicating and expanding the program to serve indigenous communities in Chiapas, Mexico.
Piatra Neamt, RomaniaGabi Paun is a HealthRight-trained Peer Health Educator (PHE), a Roma Woman, and one of the recent co-founders of the Center for Community Development Neamt, a Romanian NGO working to improve the health of the Roma community – including confronting an alarmingly high rate of TB. 
Gabi and her fellow PHE’s are among HealthRight’s many Romanian partners who will continue the services HealthRight initiated, once HealthRight concludes its Romania TB Control Partnership Project here in 2007. Over four years, HealthRight has partnered with national ministries as well as local providers and community members to increase awareness of TB and develop the long-term capacity of the Romanian health care system to prevent the spread of TB and treat those who have become infected.
HealthRight has provided extensive training for health professionals as well as PHE’s and other community members, strengthening their knowledge of TB and their ability to prevent and treat the disease. This has included developing a successful incentive model for TB patients, creating teaching materials for the Romanian education system, and launching a massive media campaign to raise public awareness.
By emphasizing the fundamental importance of local partnerships, HealthRight aims to build local capacity and become an instigator for continued success in the years to come. At the same time, HealthRight projects strive to develop replicable solutions that can be applied and adapted both locally in communities around the world.
TB Control in Chiapas. As HealthRight’s TB Control project in Romania passes the mantle to its local partners, HealthRight is expanding our work in the Mexican state of Chiapas to address an endemic TB problem among indigenous communities. This new initiative will build upon our over 13 years of experience in Chiapas, and will apply the lessons in community mobilization for TB awareness, prevention, and treatment that have been learned in Romania and elsewhere.
While the Mexican National TB Program has achieved nearly 90% national coverage following the WHO-endorsed DOTS plan, the southern state of Chiapas lags far behind. It is estimated that Chiapas - largely rural, poor, and indigenous - has achieved only 20% coverage. This disparity has culminated in a TB rate in Chiapas many times higher than that of the rest of the country.
The TB Control project will mobilize providers and community members to improve TB case detection and treatment rates, while expanding TB knowledge in the municipalities of Altamirano, Sitala and Chilon in the Ocosingo jurisdiction of Chiapas. These three municipalities contain some of the poorest communities in Mexico and face a heavy TB burden.
HealthRight’s efforts will focus on training local organizations and health professionals to educate the community, identify cases, and implement care. This will include training amigos – community members who oversee and assist TB patients to ensure treatment completion - and building the TB treatment capacity of the promotores de salud - community health workers who play an active and important role in the Mexican health system.
In turn, the lessons learned and the skills developed in Chiapas will be used to disseminate a successful, replicable model for TB prevention and care to other regions in Mexico, as well as to projects around the world.