TB Dots

DOTS represents the best strategy for coordinating TB services within the broader health system, mobilizing wide support
at the operational level, reducing TB incidence, and preventing further drug resistance.

TB CARE II - Quality Improvement Handbook for TB and MDR-TB Programs

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In recent years, national health programs have expanded their focus to include not only improving access to care, but also improving the quality of care received by patients and communities. As part of quality assurance for many clinical diseases, including tuberculosis (TB),
international and national evidence-based standards and guidelines have been developed. Having explicit standards and guidelines helps ensure high-quality care, better health outcomes, and cost effective treatments. In addition, they provide a reference point for assessing provider or system performance and quality of care. It is important to note, however, that adherence to these guidelines is not just a result of the development and dissemination of them, but of integrating the guidelines as part of a quality management program.
 
The USAID funded TB CARE II project recently conducted assessments in Bangladesh, Zambia, and Kenya to investigate factors influencing provider compliance to evidence-based TB guidelines and standards highlighted numerous factors that affected compliance. Overall, it is clear from the findings that a number of challenges continue to affect the ability of health providers to adhere to clinical and programmatic guidelines to maintain a consistent quality of TB services.  These challenges are related to provider skills and knowledge gaps, a lack of monitoring and supervision, and regular reviews of performance data. The Quality Improvement Handbook provides key principles and operational steps that will assist in improving the quality of TB and MDR-TB services in resource-constrained settings.
 
This manual is intended for health personnel working in health facilities that diagnose and treat TB patients as well as for administrative staff working in the management of health services at the health facility, sub district, or district levels. The purpose of this manual is to explain how to apply quality QA improvement strategies to help decrease the gap between TB quality of care standards and actual performance. Specifically, it provides guidance to Quality Improvement Coordinators to: 1) Identify and prioritize problems based on data and 2) develop and monitor action plans to solve problems.
Handbook cover page

TB CARE II Bangladesh: Completing TB Treatment to Prevent Drug Resistance

Completing TB Treatment to Prevent Drug Resistance

Funded through the US Agency for International Development (USAID), the TB CARE II Project is a five year cooperative agreement awarded in September 2010 to a consortium led by University Research Co., LLC. This video was developed to encourage tuberculosis (TB) patients to complete the full course of TB treatment and prevent development of multi-drug resistant TB.

Country Program: 

TB CARE II Bangladesh: TB in Children

TB in Children

Funded through the US Agency for International Development (USAID), the TB CARE II Project is a five year cooperative agreement awarded in September 2010 to a consortium led by University Research Co., LLC. This video was developed to encourage parents in Bangladesh to have their children tested and treated for tuberculosis (TB) at the nearest health facility.

Country Program: 

TB CARE II Introduces High Level Workshop to Close the Gap on Drug-Resistant TB Among Children

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Globally, few children with drug-resistant (DR) tuberculosis (TB) are identified, diagnosed, and given an appropriate treatment. Although advances have been made in critical high burden countries such as Bangladesh to increase access to quality care and treatment for DR TB, this disease is still considered largely to be a problem for adults, and children who are infected remain too often in the shadows, unable to access care.

Assessments of Providers Adherence to TB Evidence Based Standards and Guidelines in Bangladesh, Zambia, and Kenya

Despite the availability of TB guidelines/ standards in high burden TB countries, provider adherence remains a challenge. In most cases, provider adherence to guidelines is not a problem of individual performance, but a problem located in the health system itself – at the political, health services, community, and patient levels.
 

Reducing TB Delays: Evaluating the Frequency and Causes of Delays in Bangladesh and Swaziland

In 2011-2012, TB CARE II undertook a study to understand TB patients’ delays and inform the development of an integrated set of recommendations for TB program managers and service providers regarding the appropriateness of different strategies for reducing patient factor delays in accessing TB diagnostic and treatment services.
 

Management of Multidrug-Resistant Tuberculosis in Children: A Field Guide

TB CARE II recently introduced a new field guide on the management of pediatric Multidrug-Resistant Tuberculosis (MDR-TB) at the Union World Conference. This guide is the first of its kind to address the neglected issue of drug resistant TB among children, and was developed in coordination with the Sentinel Project on Pediatric Drug-Resistant Tuberculosis at Harvard University.

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