World Health & Population

World Health & Population 12(4) March 2011 : 5-13.doi:10.12927/whp.2011.22235

Engaging Informal Providers in TB control: What Is the Potential in the Implementation of the WHO Stop TB Strategy? A Discussion Paper

Berthollet Bwira Kaboru, Mukund Uplekar and Knut Lönnroth

Abstract

The World Health Organization (WHO) Stop TB Strategy calls for involvement of all healthcare providers in tuberculosis (TB) control. There is evidence that many people with TB seek care from informal providers before or after diagnosis, but very little has been done to engage these informal providers. Their involvement is often discussed with regard to DOTS (directly observed treatment – short course), rather than to the implementation of the comprehensive Stop TB Strategy.

This paper discusses the potential contribution of informal providers to all components of the WHO Stop TB Strategy, including DOTS, programmatic management of multi-drug-resistant TB (MDR-TB), TB/HIV collaborative activities, health systems strengthening, engaging people with TB and their communities, and enabling research.

The conclusion is that with increased stewardship by the national TB program (NTP), informal providers might contribute to implementation of the Stop TB Strategy. NTPs need practical guidelines to set up and scale up initiatives, including tools to assess the implications of these initiatives on complex dimensions like health systems strengthening.

 

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