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Article
Publication date: 6 November 2007

Allaby Martin, Christine Preston, Laxmi Byanjankar, Dirga S. Bam, Shanta Bahadur Pande, Sushil Chandra Baral and James N. Newell

The purpose of the paper is to show that, despite comprehensive coverage of services for TB provided by a public‐private partnership for TB control in Patan, a city in Nepal, case…

Abstract

Purpose

The purpose of the paper is to show that, despite comprehensive coverage of services for TB provided by a public‐private partnership for TB control in Patan, a city in Nepal, case finding is low, compared with the target based on an Annual Risk of Tuberculosis Infection (ARTI) of 4 per cent. Doubts have been raised as to the appropriateness of the target. The objective of the study was to estimate the number of new TB cases occurring in Patan, to assess whether the target was appropriate.

Design/methodology/approach

In the paper doorstep interviews were conducted with all households in the study area, followed by in‐depth interviews of households with possible or probable TB cases. The survey findings were validated against the patient registers of the five DOTS centres in Patan.

Findings

The paper finds that, among the study population of 36,918, the household survey identified 17 smear‐positive TB cases (none privately‐treated) and 24 smear‐negative/extra‐pulmonary cases (including four privately‐treated cases). Validation against the DOTS patient registers indicated that the survey was 54 per cent complete. After adjusting for incompleteness, the number of smear‐positive cases in the study area was estimated as 31, equivalent to an incidence of 85 smear positives per 100,000 population and an ARTI of 1.7 per cent.

Originality/value

The paper shows that using the ARTI may lead to misleadingly high targets for urban TB control. Unrealistically high targets may cause TB workers to become demoralised, and useful strategies to be abandoned. Therefore, further work is needed to identify better ways of setting targets.

Details

Journal of Health Organization and Management, vol. 21 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 6 November 2007

Cassie Thomas, James N. Newell, Sushil C. Baral and Laxmi Byanjankar

The purpose of the paper is to show that community involvement is a successful way of overcoming certain barriers to the successful management of the current tuberculosis…

1146

Abstract

Purpose

The purpose of the paper is to show that community involvement is a successful way of overcoming certain barriers to the successful management of the current tuberculosis epidemic, namely delayed presentation and non‐completion of treatment. Volunteers are an important resource for engaging with the community. This research, conducted in an urban TB treatment centre in Nepal, seeks to investigate the motivations of TB volunteers, and how these motivations can be increased to involve volunteers, and the community, in fulfilling their maximum potential in delivering successful TB treatment programmes.

Design/methodology/approach

Semi‐structured interviews were carried out with 26 TB volunteers, followed by volunteer discussion groups. Topics covered included: detailed accounts of the volunteers' many and varied roles; motivations – how they initially became involved and why they continue to be involved; incentives for volunteering; problems they have encountered; family and friends' attitudes to their volunteering; and the future of TB volunteering.

Findings

The findings show that the TB volunteers are involved in many important roles. Volunteers initially became involved, having been asked or informed about the programme by area committee members, staff or friends. Most were also involved in other voluntary work.

Originality/value

This paper gives recommendations for volunteer programmes in developing countries including: sustained communication and contact between volunteers and the organisation; volunteer programmes based in a centre with an established community focus; flexibility of time commitment; regular recruitment drives for volunteers from different generations and status levels; and the use of training as a possible incentive for volunteering.

Details

Journal of Health Organization and Management, vol. 21 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

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