U.S. Government Global Tuberculosis Strategy: Improve Access

Men on cots in a TB clinic.

Improve Access to High-quality, Patient-centered TB, DR-TB and TB/HIV Services

To reach the ultimate goal of a world free of tuberculosis (TB), USAID will work with the global community to achieve universal access to high-quality, patient-centered services for TB, drug-resistant TB (DR-TB) and TB-HIV. For this to happen, USAID must address challenges to access, such as cost of services, distance to facilities, hours of operation, and social stigma. The U.S. Government will help countries get TB services to populations at high risk of TB by:

  • Providing support for an enabling environment that includes social support packages
  • Expanding and strengthening a comprehensive, high-quality diagnostic network
  • Developing a patient-centered care and treatment approach

Community Health Worker, Fatima Khadem, Brings TB Services to People’s Door Steps

Photo of Afghanistan community health worker Fatima Khadem sorting TB records and reports. Photo credit: Nazir Ahmad Rahmani, Challenge TB
Photo credit: Nazir Ahmad Rahmani, Challenge TB

Afghanistan faces many challenges including the provision of health services, especially in area of TB. In 2009, the Ministry of Public Health and the National Tuberculosis Program initiated a community-based approach to bring TB services to people’s door steps. The community-based directly observed therapy short-course (CB-DOTS) intervention is supported by USAID in six different provinces to increase universal access to TB services. Projects include early case detection, prevention, increased community awareness and treatment of TB patients. Through the program, almost 16,000 community health workers were trained to identify presumptive TB cases and on standards for referral to diagnostic centers and on DOT provision for TB patients in their communities.

Fatima Khadem is a community health worker living in Jerbrail Village, in Herat city. She is committed to helping people in her city live a healthy life. In 2009, Fatima was trained in CB-DOTS and is responsible for referring presumptive patients for diagnosis and educating people about TB symptoms and treatment. She has referred 2,100 presumptive TB patients to hospitals for testing, which ultimately led to 280 people being diagnosed with TB. In addition, Fatima has supported close to 600 TB patients in her community undergoing DOTS. Fatima’s work has been outstanding. “I feel satisfied when I see that a TB patient has found her/his normal and healthy life,” Fatima says. She wishes for a healthy life for her family, village and all people around the world. It is women like Fatima that are transforming health in their communities.

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Last updated: September 18, 2019

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