Young children are at increased risk of contracting tuberculosis from adults with infectious forms of the disease. Infection can be prevented by giving daily or weekly medicines for 3-6 months. Despite availability of such preventive treatment many children in Ethiopia die of TB.
The objectives of the TB Reach Wave 7 ‘Improving TB Preventive Treatment among Under-five Children through Engagement of Women’s Indigenous Associations in Ethiopia’ project were to: (1) increase TPT initiation rates from 53% to 98% among under-five children in the project zones; (2) To increase TPT completion rates by 50% from baseline. We implemented the project in Yeka sub-city of Addis Ababa and Gamo and Goffa zones of South Ethiopia region.
KNCV deployed a women-led, innovative community-based treatment support strategy through Iddirs which are membership-based indigenous local associations of people who have voluntarily entered into an agreement to help each other to improve initiation and completion rates of TPT among under-five children in the project zones. We partnered with and built the capacity of a local NGO, Love in Action Ethiopia (LIAE).
Our key interventions included capacity building; out-reach based contact investigation and TPT; and strengthening monitoring, and evaluation. We first mapped, selected, and conducted capacity building of women only Iddir members and focal persons from each selected district which in turn identified additional volunteers in the community.
The selected Iddir focal persons and members received training on the basics of TB with a focus on TPT, and on COVID-19 preventive measures. The volunteer women conducted home-based symptom sceening, referred eligble contacts to the nearby health facility, and ensured they receive TPT or other treatment as per the national guidelines, and monitored treatment adherence and completion through regular visits.
“For me, there is no other blessed work than saving the lives of children” said Tadelech Eshetu, a community volunteer from Arba Minch, after having completed the training on how to detect and link eligible children for TB preventive treatment (TPT). “My awareness about TB disease is completely transformed and now I can help my community to prevent it,” remarked Beza Akalu, another volunteer woman from Addis Ababa.
Mothers/guardians of children who completed at least 95% of the recommended doses received a certificate of completion. Community mobilizers collected weekly progress reports from Iddir focal persons, and then aggregated the data and submitted to zonal project coordinators, who subsequently submitted to the central coordinators. We also organized quarterly review meetings where planning, achievements and challenges were discussed.
We worked with 67 women-only iddirs whose interventions led to a 351% increase in the number of child contacts screened (from 351 to 1620), and five-fold increase in TPT enrollement (from 320 to 1550). TPT completion rate was 99% in under-five children.
The results were published in a peer-reviewed journal and can be accessed here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9310159/
The national TB program now recommends Iddirs among community based support groups for TB care.
The TB Reach Wave 7 ‘Improving TB Preventive Treatment among Under-five Children through Engagement of Women’s Indigenous Associations in Ethiopia’ project was funded by Stop TB Partnership.
Watch the project video for more information: