Treatment Supporters and Their Impact on Treatment Outcomes In Routine Tuberculosis Program Conditions In District Rawalpindi, Pakistan

Background: Tuberculosis (TB) is a major cause of mortality and is affecting millions of people in third world countries. In DOTS patients are monitored facility based and treatment supporter based; by these two ways patients are observed for the treatment. The aim of the study was to explore the role of treatment supporters and their impact on the treatment outcomes. Material and Method: The study was a cross-sectional survey within routine TB control program operational context. All sputum smear positive TB patients diagnosed, registered in public sector, urban and rural diagnostic centre during year 2008 with available outcomes were included in the study. Data was collected during August- October 2010 from 15 health facilities of 451 patients. Results: The majority of the patients (89.6%) were provided with treatment supporters. In 404 (89.6%) cases in which treatment supporters were provided, 203 (50.2%) were lady health worker, 46 (11.4%) were community health worker and health facility worker, and 155 (38.4%) were family member and community volunteer. 384 (85.1%) were categorized as treatment success, 31 (6.9%), as transferred out, 17 (3.8%), as dead, 16 (3.5%) as defaulted and three (0.7%) as treatment failure. The treatment success rates in patients supervised by lady health worker, community health worker and health facility worker, and family member and community volunteer was 93.1%, 89.1% and 73.5%, respectively. Conclusions: We found a significantly higher treatment success (93.1%) in patients supervised by lady health workers compared to other types of treatment support. The overall treatment success rate was 85.1%.DOI: http://dx.doi.org/10.3329/jom.v14i1.14535 J MEDICINE 2013; 14 : 40-46

Download Full-text

Health Facility-based Counselling and Community Outreach are Associated with Maternal Dietary Practices in a Cross-sectional Study from Tanzania

10.21203/rs.3.rs-155318/v1 ◽

2021 ◽

Author(s):

Kirk A. Dearden ◽

Ramu Bishwakarma ◽

Benjamin T. Crookston ◽

Benesta T. Masau ◽

Generose I. Mulokozi

Keyword(s):

Health Services ◽

Community Health ◽

Health Worker ◽

Health Facility ◽

Community Health Worker ◽

Children's Health ◽

Dietary Behaviors ◽

Access To Health Services ◽

Dietary Practices ◽

Access To Health

Abstract Background: Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania.Methods: Data come from a two-stage, randomized baseline survey among 5,000 female primary caregivers prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression.Results: A third of the sample (34.1 percent) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0 percent). 68.0 percent had never had a community health worker (CHW) speak to them about their children’s health and 9.4 percent had participated in a women’s group. Only 8.0 percent of mothers ate more than usual during pregnancy and 7.1 percent ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95 percent CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving ANC and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 hours. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 hours. Conclusions: Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

Download Full-text