Acceptability of community and health facility-based directly observed treatment of tuberculosis in Tanzanian urban setting

Wandwalo, Eliud; Makundi, Emmanuel A.; Hasler, T.; Mørkve, Odd

doi:10.1016/j.healthpol.2005.11.010

Cited by 18 publications

(29 citation statements)

References 11 publications

(9 reference statements)

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“…CHWs have been employed to visit homes to detect symptomatic patients and facilitate sputum testing, to visit patients in their homes to ensure treatment compliance, to reduce stigma, and to assist in the treatment of patients in health clinics by, for instance, directly observing patients taking their medications (27,142).…”

Section: Tuberculosis Controlmentioning

confidence: 99%

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

664

671

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Over the past half-century, community health workers (CHWs) have been a growing force for extending health care and improving the health of populations. Following their introduction in the 1970s, many large-scale CHW programs declined during the 1980s, but CHW programs throughout the world more recently have seen marked growth. Research and evaluations conducted predominantly during the past two decades offer compelling evidence that CHWs are critical for helping health systems achieve their potential, regardless of a country's level of development. In low-income countries, CHWs can make major improvements in health priority areas, including reducing childhood undernutrition, improving maternal and child health, expanding access to family-planning services, and contributing to the control of HIV, malaria, and tuberculosis infections. In many middle-income countries, most notably Brazil, CHWs are key members of the health team and essential for the provision of primary health care and health promotion. In the United States, evidence indicates that CHWs can contribute to reducing the disease burden by participating in the management of hypertension, in the reduction of cardiovascular risk factors, in diabetes control, in the management of HIV infection, and in cancer screening, particularly with hard-to-reach subpopulations. This review highlights the history of CHW programs around the world and their growing importance in achieving health for all.

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Section: Tuberculosis Controlmentioning

confidence: 99%

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Perry

Zulliger

Rogers

2014

Annu. Rev. Public Health

664

671

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“…[6][7][8][9][10][11][12][13][14][15][16][17] Malawi's National TB Programme has introduced a guardian-based strategy of direct observation of treatment which has reduced costs for patients. 12 Costs to patients and their households of careseeking from illness onset to diagnosis are less well-documented.…”

Section: Introductionmentioning

confidence: 99%

Can Malawi's poor afford free tuberculosis sevices? Patient and household costs associated with a tuberculosis diagnosis in Lilongwe

Kemp

Mann

Simwaka

et al. 2007

Bull World Health Organ

113

108

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Objective To assess the relative costs of accessing a TB diagnosis for the poor and for women in urban Lilongwe, Malawi, a setting where public health services are accessible within 6 kilometres and provided free of charge. Methods Patient and household direct and opportunity costs were assessed from a survey of 179 TB patients, systematically sampled from all public and mission health facilities in Lilongwe. Poverty status was determined from the 1998 Malawi Integrated Household Survey (MIHS). Findings On average, patients spent US$ 13 (MK 996 or 18 days' income) and lost 22 days from work while accessing a TB diagnosis. For non-poor patients, the total costs amounted to 129% of total monthly income, or 184% after food expenditures. For the poor, this cost rose to 248% of monthly income or 574% after food. When a woman or when the poor are sick, the opportunity costs faced by their households are greater. Conclusion Patient and household costs of TB diagnosis are prohibitively high even where services are provided free of charge. In scaling up TB services to reach the Millennium Development Goals, there is an urgent need to identify strategies for diagnosing TB that are cost-effective for the poor and their households.

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“…On the other hand, very high expenditures were determined in the Haitian study, [17] which evaluated the total direct medical cost per PTB patient to be US$432.00. The Malaysian, [3] Ethiopian, [12] Brazilian, [18] and Tanzanian [19] studies reported that the total direct medical cost of treating a PTB patient was US$95.60, US$189.50, US$103.00, and US$115.30, respectively. However, the study conducted in Bangladesh [8] showed that the direct medical cost of PTB patient was lower at US$77.00.…”

Section: Discussionmentioning

confidence: 99%

Cost of Tuberculosis Relapse in Yemen: A Nested Case-Control Study

Anaam¹,

Ibrahim²,

Serouri³

et al. 2017

JPPCM

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Acceptability of community and health facility-based directly observed treatment of tuberculosis in Tanzanian urban setting

Cited by 18 publications

References 11 publications

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Community Health Workers in Low-, Middle-, and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness

Can Malawi's poor afford free tuberculosis sevices? Patient and household costs associated with a tuberculosis diagnosis in Lilongwe

Cost of Tuberculosis Relapse in Yemen: A Nested Case-Control Study

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