基于社区的干预措施改善南非农村的结核病治疗结果

Bambisanani是一个在南非东开普省农村地区经营的社区组织。结核病(TB)是南非的主要死因 - 2010年,仅在东开普省,超过10,000人死于结核病。认识到改善和加快南非TB努力的急切重要性,BAMBISANANI组织得到了支持布里斯托尔美犬基金会,,,,implemented the WHO ENGAGE-TB approach between November 2013 and August 2015.

参与-TBapproach was developed by WHO to provide guidance on policies and programmes that are needed to support NGOs in integrating TB into their community-based work in maternal, newborn and child health, HIV care, primary health care, education, agriculture and livelihood development programmes.

该方法优先考虑加强社区在结核病护理中的作用,尤其是在情况通知和治疗依从性的情况下。BAMBISANAI项目通过社区对话会议和社区会议聘请了社区领袖,妇女和青年团体,传统治疗师和其他社区结构。强调社区参与度优先考虑建立一个稳定的环境,以照顾和支持社区结核病管理。该方法成功地提高了结核病诊断和治疗率以及在社区层面上产生收入的活动。

作为项目的一部分,一个文件系统被发展ped in the participating clinics, where previously poor filing systems made it difficult to track and verify TB client information. The entire province has since adopted this simple yet effective system. The project prioritized joint-training of all participating bodies. The joint trainings have contributed to the elimination of competition, and strengthened professional networks. A partnership between Bambisanani and the Mine Workers Development Agency led to the development of 670 home gardens in Bizana, which were developed to help supplement the income of ENGAGE-TB clients below the poverty line.

该省的贫困基础设施也导致了参与TB员工追求目标的可访问性挑战。Bambisanani开发了一种运输摩托车模型,以便更容易进入难以到达的区域。这些摩托车仍用于跟进停止治疗的患者。

这project has created long-term platforms for sustainability and there are ongoing plans by the Department of Health to further engage community health workers so that they can get paid, provide services and continue their good work. The community health workers are well trained and, in some clinics, they even work in the TB clinic itself.

志愿者进入社区的机会确保了结核病患者和潜在的患者,并将其与适当的筛查联系起来。该项目支持的十个医疗机构的数据表明,自该项目成立以来,社区卫生工作者将诊断和通知的四分之一的新结核病案件诊断出来。

这community engagement approach contributed towards improving treatment outcomes. Data from the clinics visited showed that community volunteers supported TB patients to ensure that they were treated and cured. Data from health centers show improvements in treatment outcomes from 83% prior to the project to 94% at the time of documentation. Treatment outcomes are calculated as the number of TB patients who are successfully treated and cured with support from community health workers as a percentage of the total number of TB patients successfully treated and cured.

Bambisanani的该项目的结果表明,基于社区的干预措施有可能在改善结核病患者的预后,尤其是在将未诊断的患者连接到测试和治疗方面具有显着影响。同时,与社区中其他团体和组织的伙伴关系意味着,这种类型的项目对能力建设和改善基础设施的连锁反应远远超出了结核病。

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