Strategic Areas

Tuberculosis

QAP is improving access to and effectiveness of tuberculosis (TB) prevention and treatment programs through support to quality improvement and redesign by facility-based teams. The project also develops job aids and computer-based training tools to improve tuberculosis case management.

• In South Africa, QAP is assisting the Departments of Health in Mpumalanga and KwaZulu-Natal Provinces to improve the case management of tuberculosis, a leading cause of morbidity and mortality in the country. Baseline assessments have been carried out to identify quality gaps, and based on the results, processes for prevention/education, case detection, case confirmation (lab/diagnosis), and case management (including symptomatic cases, confirmed cases, and prevention of other infections) have been redesigned. Basic training has been provided to health workers to improve tuberculosis case management knowledge and skills, and job aids have been developed to help providers internalize basic skills about case management. Facility staff are conducting monthly reviews of service statistics and patients records to ensure appropriate follow-up of patients.
• In Bangladesh, QAP is working along with the NGO Service Delivery Program to expand access to and quality of TB services through a network of over 300 clinics. A systems analysis will be carried out to assist in designing systems to improve identification, referral, and case management systems.
• In Cambodia, QAP conducted an assessment of TB services in the private sector to assist the government in developing strategies to increase private sector involvement in the National TB Program.
• In Russia, QAP is working to strengthen the Russian healthcare system’s capacity for addressing TB-HIV co-infection and to develop and implement the functional integration of TB and HIV services. Working with health authorities and service providers, QAP/Russia is designing a model system of treatment, care, and support for TB patients as part of international efforts to control the dual epidemics of tuberculosis and HIV/AIDS.
• The Tuberculosis Case Management CD-ROM, which has received several awards in international industry competitions, has demonstrated that health workers can improve their clinical practices as well as improve compliance with TB DOTS treatment guidelines. In Bolivia and Ethiopia, QAP field tested the effectiveness of TB Case Management CD-ROM to train health workers in all aspects of preventing, diagnosing, and treating TB by using WHO's DOTS approach. Through this self-paced interactive program, users are able to validate their knowledge of both diagnosis and treatment of TB through a built-in pre-course review and a post-course test. The multi-media presentation of the subject provides each user a chance to practice those acquired skills, using a set of standard diagnostic tools, in a simulated clinic examination room.
  

Related QAP Publications:

• Bangladesh: NGO and Public Sector Tuberculosis Service Delivery—Rapid Assessment Results
• The Effectiveness of TB DOTS Supporters in South Africa
• Reducing Treatment Default Among Tuberculosis Patients in the Philippines
• Situational Analysis of TB-HIV Co-infection in Russia and Four QAP Project Regions: Samara, Saratov, Orenburg, and St. Petersburg
• Treating Tuberculosis in the Private Sector: Cambodia