Strengthening TB Control Programs in Pakistan to Save Lives

March 22nd, 2022 | Story


Identifying, diagnosing, and treating people with multi-drug resistant tuberculosis (MDR-TB) is challenging. In Sindh, Pakistan’s most populous province, 14-year-old Tajal was experiencing a cough, evening fevers, chest pain, and weight loss for more than two months. Stretching their finances, her parents took her to a private clinic, where she was prescribed antibiotics. However, Tajal’s condition worsened, and she lost interest in playing with her brothers and helping her mother around the house.

As part of the USAID Integrated Health Systems Strengthening and Service Delivery (IHSS-SD) Activity’s support to Pakistan’s Provincial Tuberculosis Control Program, Noshaba, a social mobilizer, has been trained to identify, diagnose, and connect TB patients to free, government-provided treatment. Noshaba noticed Tajal’s condition when she visited her home to perform contact tracing for Tajal’s uncle, who is a registered MDR-TB patient. During the visit, Noshaba explained that TB is serious but with timely diagnosis and consistent treatment, curable.

Noshaba collected sputum from Tajal’s family for testing and, when the results came back, notified them that Tajal had MDR-TB. With Noshaba’s support, the IHSS-SD team enrolled Tajal at the nearest Programmatic Management of Drug-Resistant Tuberculosis site. The site is run by the government and, in addition to free treatment, it provides a monthly stipend to help people with TB pay for travel to site for check-ups and for nutritious food to support a successful course of treatment.

In addition to training, the USAID IHSS-SD Activity provides social mobilizers like Noshaba with on-the-job coaching as they apply what they learn, such as how to educate people about TB and help those with diagnosed TB register for treatment.

“We give awareness about TB to the male and female family members separately, keeping the cultural sensitivity. We also collect sputum, tag the sample jars, fill out the laboratory forms, submit the samples to the laboratory, and enroll [people in] treatment in case of positive results,” says Noshaba.

The IHSS-SD Activity’s work with the Provincial TB Control Program is helping people with limited resources in Sindh access the free services provided by the government. The IHSS-SD team has conducted sessions to help make than 2,000 people in Sindh aware of TB diagnosis, treatment, and the resources available to them. With assistance from the IHSS-SD team, the Provincial TB Control Program has identified and registered 22 people with drug-sensitive TB and five with DR-TB.

A timely diagnosis and accurate information about TB can be lifesaving. Tajal is adhering to treatment and feeling better. “She is improving gradually and now [is able to help me with the] home chores,” says her mother.

About JSI’s TB Expertise

JSI helps countries leverage new tools and approaches to mitigate TB at a time when progress is needed more than ever, due to the impact the COVID-19 pandemic has had on defeating TB. We manage TB programming in 17 of USAID’s 24 priority countries, with a focus on improving prevention, detection, diagnosis, and treatment through service delivery and health system strengthening. We help get resources directly into the hands of national and provincial government partners—respecting and trusting government systems and minimizing risk and administrative burdens—so that TB programs can focus on applying evidence-based approaches to improve health outcomes.

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