b) Community Participation & Role of Voluntary Organizations
AU : Spinosa AV, Bales V, Pesanti E & Hadler J
TI : Treatment of tuberculosis by community workers.
SO : BULL IUAT 1976, 51, 695-700.
DT : Per
AB :

A TB control project was undertaken in 1971 in South Western United States, in the reservation of the Navajo Indians (120,000 living in a vast, high, arid land). The specific problems in treating TB among the Navajo are described. The specific problem was that, despite efforts of medical personnel and available treatment facilities, only 25% of the active TB cases at home were taking their medications. The cause was found to be the inadequate number of trained personnel to do the necessary tasks to keep patients on medication. To achieve the project’s goal of increasing the percentage of patients at home, taking medication in one year, to 80%, job analyses were done to develop outlines of the duties, knowledge and skills required of TB workers, the case register clerks and the project Director, by interviewing the physicians, nurses and administrators working on the project. Subsequently, 4 weeks of training (carefully designed around the job requirements of the trainees) was given. An evaluation of the project indicated that 80% of active cases at home were on medication after a year and 96% in the fourth year. Only 4% of cases were lost to supervision, active cases in the hospital were down from 50% to 15%, hospital stay was down from 70 to 18 days, a quarter of active cases were on intermittent therapy, new case rates were down from 150 to 73 per 100,000. A subjective evaluation performed through the use of interviews and questionnaires revealed positive and negative feelings of the workers to different issues of TB work. The conclusions were that TB workers, recruited from the indigenous population and carefully trained, could greatly benefit a TB programme; such a project was best implemented by an objective-oriented approach focussing on the problem, cause, objective, solution and evaluation. These concepts could be successfully utilized in any TB programme, whether it be rural or urban, in a developed or developing nation.