This document provides an overview for NGOs and civil society organizations interested in becoming involved in community-based tuberculosis (TB) programming. It discusses the need for community involvement in TB control efforts. The document outlines key components of TB programs, such as partnership, social mobilization, and referral systems. It also provides guidance on getting started, including initial questions for NGOs to consider and potential program areas like active case finding, directly observed therapy, and special populations. The goal is to encourage NGO participation in addressing TB at the community level.

1. Community Based TB
Programming: Seeking your
Input
Draft- Engaging NGOs and Civil Society
Organizations in Community Based TB
activities: A Primer and Reference Manual
Devasena Gnanashanmugam
Consultant, CORE Group

2. Why do we need yet another
document in TB?
• The past
• TB control delegated to Ministries of
Health/ NTPs
• NGOs/ Civil Societies not encouraged to
participate
• The problem
• Health facilities overburdened by TB
disease (fueled by the HIV epidemic)
• Although a “social disease”, community
involvement was lacking

3. Why another one?
• The present
• NGOs and CSOs are encouraged to get
involved
• But they aren’t quite sure how…
• The need
• More awareness about scale and impact of
TB on communities
• Practical steps on getting started to
address TB

4. Intent of the document
• Audience: NGOs and CSOs
• Those interested in TB by any/ all of the
following:
• Starting new efforts
• Expanding to or linking to existing programs
• Basic overview of TB & how to control it
• Reader is referred to more exhaustive
sources
• Written to ENCOURAGE involvement

5. A sample of included items…
• educate and mobilize communities about TB
• find men, women and children with symptoms
and get them where they need to go
• collect sputum samples to send to labs for
diagnosis
• trace contacts—men, women and children
who have been exposed to someone with TB
• provide patient-friendly treatment support over
the many months of taking medicine
• locate people who stopped their treatment,
and help get them back on track.

6. Key components for TB
programs
• Partnership
• Focus on Participation
• Invest in Social Mobilization and Behavior
Change
• Ensure a Strong Referral System
• Integrate programs into existing health
systems and services

7. Current TOC: the Basics
• Global TB Burden
• A Brief History of the Fight Against TB
• The current STOP TB Strategy

8. TOC: How to get Started
• Infection control.
• Care for your health providers.
• Assessing viability of getting involved and
possible roles
• Understanding the overall TB program
landscape
• Assess your NGOs’ Strengths: Initial
questions to ask

9. Initial Questions to Ask
• Do you have existing links in the Ministry of Health,
Education, or other relevant entities?
• What is your current area of expertise? How might you best
integrate TB with your current activities?
• Your NGO’s location
• What are the local rates and patterns of TB?
• Will this involve drug resistant- TB?
• Are you in one of the high burden countries?
• Will you need to consider HIV co-infection?
• If your expertise is advocacy
• Can you use your advocacy/ messaging for consistent
messaging or training in ACSM in TB?
• Can you leverage your capacity to reach out to inaccessible
and remote areas, including conflict zones?

10. Key Program Design Elements
• Overview of DOTS & how to expand
current direct observed therapy goals
• Potential Program Areas
• Special Populations

11. DOTS Elements
• Sustained political commitment to TB control
• Case Detection by quality assured
bacteriology
• Provide standardized treatment with
supervision, and patient support
• An effective drug supply and management
system
• Monitor and evaluate performance and impact

12. Potential Program Areas
• Active Case Finding and Contact
Investigations
• Directly Observed Therapy (DOT)—Watching
patients take their pills
• Methods to Improve Adherence
• Community Health Workers and Volunteers
• Integration of TB with other services
• Advocacy, Communication, Social
Mobilization and Behavior Change
Communication

13. Potential Program Areas
• Stigma
• Training and Supervision to Build Local
Capacity and Capacity building
• Public- private partnership mix
• Operations/Implementation Research

14. Special Populations
• Gender
• TB/ HIV
• Drug resistance (drug-resistant TB)
• Pediatric TB: TB in Children
• Access to Vulnerable or “Hard to Reach”
Populations
• Engaging TB patients
• People in Urban settings

15. Conclusion
• Pitfalls/ Lessons learned
• Key documents
• Your thoughts/ ideas/ comments?