KARACHI: Engagement of lady health workers (LHWs) has led to early and increased identification and reporting of tuberculosis cases at public and private health facilities in selected rural areas of Sindh, according to a recently conducted project whose findings were shared at an event held on Wednesday at a local hotel.

The programme was organised by Mercy Corps (MC), an NGO working in various sectors including health in Pakistan, in collaboration with the United Nations Office for Project Services, Stop TB Partnership-Pakistan, and the Sindh government.

The one-year pilot project titled ‘Engaging TEAM (train, empower, and mobilise communities) to end TB’ was carried out jointly by MC, Sindh LHWs programme and provincial TB control programme, from October 2017 to June 2018 in selected areas of Sanghar, Umerkot, Ghotki, Naushahro Feroze, Badin and Shikarpur districts.

More than 800 LHWs were trained for TB screening under the project aimed at increasing TB case notification by identifying suspected cases and referring them to health facilities.

Giving a presentation on the project, Aamna Rashid representing MC said that LHWs verbally screened 468,454 people during their routine household visits of their catchment population.

“Of them 3,987 TB suspected cases were referred to public and private health facilities, out of which 77 per cent cases got tested,” she said, adding that a total of 884 cases constituting all forms of TB were registered during the project.

On the lessons learnt during the project, she said that LHWs’ engagement led to early diagnosis. “Not only that, we also saw that an increasing number of TB cases were notified; from 9pc to 17pc in all its forms as compared to the same quarters of previous year.”

The verbal screening, sputum collection and outreach chest camps improved access to TB care services among the community members, especially women, she added.

Sharing findings of a study investigating factors motivating LHWs to improve their performance, she said the majority of LHWs cited appreciation from the community and officials as the major driver for productive work.

“It’s interesting to note that most didn’t mention financial gains but rather the joy of serving humanity and the reward [in the] hereafter as their main source of motivation,” she told the audience.

However, she said, many health workers were apprehensive over the implications of engaging their services in TB through monetary rewards and said that this kind of strategy might distract them from their key role and might create a culture among LHWs of reliance on monetary incentives.

“They also talked of lack of financial or other support for transporting TB patients to referral facilities,” she said.

Earlier, Dr Arif Noor, MC country director, said that the project targeted rural communities where access to TB services was challenging for both men and women.

During the question-answer session, participants from the health department, provincial TB control programme, and various NGOs working in the field highlighted gaps in the project’s methodology and shared their concerns over the health challenges the country faced. There was a consensus to strengthen the role of LHWs to help them perform better at the grass-root level.

Published in Dawn, October 12th, 2018