The webinar engaged experts in the public health, policy, program implementation, as well as a TB Champion to discuss the need to engage established community leaders and structures and tap into their local leadership to drive and sustain TB control efforts at the grassroots.
Community structures such as Self-Help Groups, youth associations, labour unions, and faith-based organizations, have immense potential to collectivize efforts and initiatives in order to conduct activities that strengthen TB awareness in the community, improve the recognition of symptoms, and promote appropriate health seeking behaviour. KHPT has been working with community structures in Karnataka and Telangana since 2019 with USAID support and found community structures referred 2730 persons with symptoms in the July 2019- March 2020 period, of which 2230 were tested and 237 were found to be positive, indicating that community structures are increasingly making quality referrals for testing based on their knowledge of TB. Due to their significant influence as organizations with social welfare as part of their mandate, they have the ability to help TB patients in a variety of ways, starting from one-on-one counselling and patient visits to mobilizing resources to support them with monetary and/or nutrition support through the treatment period.
The panellists included Dr Raghuram Rao, Deputy Director, CTD, MoHFW; Dr Rajeev Gowda, Parliamentarian; Dr Lucica Ditiu, Executive Director, Stop TB Partnership; Dr Reuben Swamickan, Division Chief, Tuberculosis and Infectious Diseases, USAID; Dr Dalbir Singh, President, Global Coalition Against TB; Mr Mohan H L, CEO, KHPT; and Mr Chandan B K, a TB Champion. The panel discussion revolved around strengthening community engagement at the grassroots through policy and programmatic guidance for community structures.
In his keynote address, Dr Raghuram Rao, Deputy Director, CTD said, “We have a renewed mission to take forward the TB agenda to end TB in 2025 through a Jan Andolan. It’s going to be very challenging, but we hope for the support of all partners, especially the communities. We are banking on our community, our community structures and civil society organizations, to work in very targeted areas to reach key vulnerable populations. I’m sure with the support of everybody, we’ll achieve our goals.”
Dr Rajeev Gowda, Parliamentarian, said, “One of the things we know, in the context of healthcare, is that for all the efforts that the govt. has taken to pull people out of poverty, it is one major illness that can pull them back. Multidimensional approaches to address TB must be a national priority and community-related interventions can make a huge difference to turn the tide.”
“Having community health workers and civil society as an entry point for information, for demystifying wrong statements, to convince people to get diagnosed and treated is very important not just for COVID and TB, but any other pandemic coming,” said Dr Lucica Ditiu, Executive Director, Stop TB Partnership. “To be protected for the future, we can empower such networks and give them responsibility, tools, information and remuneration so they can be communicators and bring down walls between people and the public health sector.”
“The larger objective of affordable, equitable and universal healthcare for TB Care only be achieved by building synergy between the government apparatus, local governments and society and deeper engagement of local communities,” said Dr Dalbir Singh, President, Global Coalition Against TB. “Many national governments and global institutions have already started investing heavily in strengthening systems through decentralization. I am sure we would not like to overlook this imperative.”
Dr Reuben Swamickan, Division Chief, Tuberculosis and Infectious Diseases, USAID, in his remarks said, “The absence of active community participation and patient centric approaches for vulnerable populations has resulted in missing TB cases and a high proportion of negative treatment outcomes. The saying ‘nothing for us, without us’ works for TB very well, when it comes to community. They are good at asking questions. If we provide them a structure and solutions, they’re going to help themselves, other patients and the community at large, and make a difference.”
Mr Mohan HL, CEO, KHPT, said, “KHPT’s approach empowers community structures, builds their perspectives, provides tools and motivates their leaders to integrate TB into their existing welfare mandate. leveraging their existing capacities. This helps them actively engage with patients’ issues in their own unique contexts and sustain efforts against the spread of TB, paving the way for increased ownership of the ‘End TB’ agenda among communities.”