Brazil: Behavior Change Communication for More Effective Tuberculosis Control

Dates: 2010-2011

Country: Brazil

Client(s): USAID

Services: Technical Assistance, Monitoring, Evaluation, and Research, Training, Capacity Development

Technical Expertise: Social and Behavior Change, Health Systems Strengthening, Infectious Diseases


Tuberculosis ranks as the third most common cause of deaths among infectious diseases in Brazil, with 4.8 thousand deaths per year. Brazil is on the World Health Organization’s (WHO) list of 22 TB High Burden Countries. In 2010, the Brazilian National Tuberculosis Control Program reported a TB incidence rate of 37.2 per 100,000 people, and 71,000 new TB case notifications.

The Behavior Change Communication for More Effective TB Control Program worked to improve TB control in selected high TB disease burden municipalities in São Paulo State. JSI provided technical assistance for behavior change communication and facilitated TB directly observed treatment, short-course (DOTS) training and supervision at the state and municipal levels. Improved TB control specifically means increasing case detection, treatment compliance and cure, as well as decreasing default and mortality. The goal was to improve TB case detection, treatment compliance, and cure rates as well as decrease treatment defaults and mortality.

The following key interventions were implemented in collaboration with the São Paulo State and Municipal TB Control Programs in the selected high TB burden municipalities:
1.Training and supervision in DOTS: More than 700 service providers were trained in the approach and 98 lab technicians were trained in quality control
2.Developing BCC strategies and providers peer-to-peer interventions for tuberculosis control, providing essential new tools and strategies to lift program impact
3.Behavior Change Communication intervention implementation: JSI provided technical assistance and capacity building to the Secretariat TB Control Program and the Municipality TB Control Program in launching the “De peito aberto” campaign in three intervention sites from July-September, 2011.
4.Impact evaluation.

The BCC for TB Program in Brazil was a one-year USAID-funded program. JSI partnered with JSB Consultoria.