WHO coordinated and facilitated initiation of projects through capacity building of the NGOs; supporting the establishment of National Coordinating Body; monitoring quality of project implementation; and facilitation of experience sharing among the implementing partners and with NTP.
The ENGAGE-TB approach is now included in the revised National community TB care guidelines of Ethiopia. Engagement of NGO/CSOs has been included in the newly revised Strategic Plan for TB. The two core WHO-recommended indicators have been included in the newly revised Health Management Information System.
Lessons learnt
All these examples show that 'partnership between government and NGOs in TB control interventions' is practical and a critical factor for positive outcomes. However NGOs might need financial support to help integrate TB services into their work, and so increase in resource allocation for community based TB interventions is important.
Commitment from the MoH and local healthcare personnel is essential too. There is need to train CHWs in various health areas, refresh their trainings, develop new tools, and streamline the system so as to reach the grass roots community level. There must also be enough motivation (monetary and otherwise) for CHWs to remain in the programme and not opt out.
Good data collection is critical to demonstrate that community-based TB integration activities have a greater impact than using health centres as point of entry to care and information; and also that multiple services when integrated work better than those working in silos.
Thus, by leveraging existing networks and services, we can reach out to the so-called hidden population at the community level to facilitate early case detection and enhance TB-prevention efforts. The strength of NGOs is their reach, spread and ability to engage communities. When NTPs engage NGOs to integrate community-based TB activities into their work, TB outcomes improve, wherein lies the success of the ENGAGE-TB programme.
Shobha Shukla, Citizen News Service (CNS)
(The author is the Managing Editor of CNS. She is supported by the WHO Global Tuberculosis Programme to report from the 45th Union World Conference on Lung Health in Barcelona, Spain. Email: shobha|AT|citizen-news.orgEmail address, website: www.citizen-news.org)
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