(The author is the Director of CNS Stop-TB Initiative and a World Health Organization (WHO) Director-General’s WNTD Awardee 2008. He writes extensively on health and development. Email: bobby@citizen-news.org, website: www.citizen-news.org )
Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower default (drop-out) rate in the female patients. Among the unreached people who need TB care, a significant number of them are likely to be poor and probably women. There is a lot more we need to do to bring in the desired change in diagnosing people with TB as early as possible and treating them with standard regimens successfully.
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"Partnering with traditional practitioners, establishing linkages with mental health programme for quality counselling, raising awareness among healthcare workers of atypical symptoms of TB in women (like psychological and emotional distress, lack of haemoptosis) are some of the initiatives we need to scale up to reach the unreached women with TB" said Mamta Jacob.
"Privacy in healthcare settings for women is also important. It is difficult for a woman to overcome social inhibitions and produce diagnostic quality sputum for TB test in a overcrowded and public setting like a public hospital for example. Also counselling is so crucial in TB control among women, especially family counselling, when a woman is the only TB patient in the family. This will go a long way to counter stigma and discrimination related to TB and also raise TB treatment literacy and infection control knowledge among family members" said Mamta Jacob.
Dr Nerges Mistry, Director of the Foundation for Medical Research, Mumbai, India, was another keynote speaker who presented the content from the National Rural Health Mission (NRHM) Module 7 which lists the role of ASHA workers in TB treatment phase. This was an eye-opener because one can only wish if this is implemented in letter and spirit to bring in a significant desired change we wish to see in TB control.
The NRHM Module 7 lists the following as the role of ASHA workers in TB treatment phase:
- ASHA workers could serve as the DOTS provider in their village and ensure compliance
- Since the treatment is of long duration, the ASHA worker has a key role in motivating the patient to complete the treatment and prevent them from stopping midway or drop out
- Recognising the side-effects of the drugs and knowing how to deal with side-effects of drugs and making sure of drug-availability at the health facility will help ASHA workers to do this more effectively
- Encourage the patient to take sufficient nutrition during treatment and moderate rest at least for the first two months
- The family of the patient should be counselled to take precautions at home especially for children and elder persons who can contract the disease quickly
- When coughing, the patient must put a protective clean cloth over his mouth to prevent spread of droplets or leave the house and cough in a nearby open space. The cloth should be washed in hot water or with disinfectant thoroughly on a regular basis.
- The patient should not have close contact with spouse, children and infants and the elderly within the family at least for two months after starting treatment. Simple hygiene precautions will help in preventing transmission of TB within the family
- ASHA workers must keep a watch on the other family members to detect early signs of TB in the members and if necessary, get them examined from time to time
- Ensure BCG vaccination of children at birth. This can help prevent TB among small children
- TB is also a st
Although women get diagnosed for tuberculosis (TB) later than men, treatment outcomes among women are better than men with higher TB treatment success rate and lower
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