Daniel G. Datiko
REACH ,Ethiopia
Title: Involving lay health workers for case finding and improved treatment outcomes in rural Ethiopia
Biography
Biography: Daniel G. Datiko
Abstract
Background: In settings with limited access to health care, engaging lay health workers is crucial in improving access and reach universal coverage for primary health care. Tuberculosis (TB) is the leading cause of mortality and morbidity with highest rates in resource-constrained settings. Thus, its prevention and control program has rich experience in engaging lay health workers. We report successful implementation of TB prevention control by engaging lay health workers in case finding treatment t in southern Ethiopia.
Methods: This is an innovative community-based collaborative project with the Ministry of Health of Ethiopia implemented in southern Ethiopia. The key interventions included familiarization, capacity strengthening, community-based intervention by engaging lay health workers - Health Extension Workers (HEWs) in TB case finding and treatment to ensure continuum of care.
Results: Lay health workers - HEWs identified more than 180,000 presumptive TB cases, collected their sputum and prepared smear collected by district field supervisors for examination. Of these, more than 9,000 smear-positive TB cases were diagnosed from the slides prepared and fixed by HEWs. Over all in the project area, more than 13,000 smear-positive TB cases and more than 29,000 all forms of TB were diagnosed and treated. The community-based intervention contributed to about 70% cases detected in the project area. More than 9,000 household contact tracing was done and screened more than 35,000 contacts, and about 2,500 under five years asymptomatic children were put on IPT in the community.
Conclusions: Engaging lay health workers in TB prevention and control has significantly increased case finding, supported treatment adherence and provision of IPT in the community. Their engagement is crucial in reaching the remote and rural communities. It is feasible to enrol lay health workers in TB case finding to improve case finding and treatment outcome in resource constrained settings.