Women’s Empowerment to End TB (WE-END TB)

What is this project?

Women’s Empowerment to End TB (WE-END TB) aims to enhance access to TB services in three rural districts (Kalaburagi, Yadgir and Bellary) in Karnataka, India, through community-based active case finding strategies that involve systematic screening and clinical evaluation of people who are at high risk of developing TB.

 

Why are we working on it?

India has set an ambitious goal to end TB by 2025, 5 years ahead of global elimination goals. TB can have particularly severe consequences for women, especially during their reproductive years and during pregnancy. Women and adolescent girls in districts such as those in Karnataka have an elevated risk of contracting TB for many reasons including poor nutritional status and low literacy rates.

An existing network of women-led Self-help Affinity Groups (SAGs) are trained to raise awareness, screen for, and encourage people with TB symptoms to get tested and treated on time. In close collaboration with India’s National TB Elimination Programme (NTEP), WE-END TB is supporting 1,400 of these women to engage more than 2 million marginalized people and find the “missing” people with TB in their villages and communities.

The project will enhance TB case-finding and treatment across 16 taluks (an administrative unit with a population of 100,000–200,000) by empowering women to systematically screen for populations at risk, including people living with HIV, miners and tribal populations who often do not receive the healthcare services they need.

The SAGs will be assisted by 24 MYRADA-supported Community Managed Resource Centres (CMRCs) present in these taluks.

 

What does it involve?

WE-END TB is centred around five key interventions:

  • Capacity building: including ‘training of trainers’ sessions aimed at educating CMRC supervisors and community resource persons (CRPs) in active case-finding strategies. Supervisors and CRPs in turn train the SAGs (approximately 2 per village) at designated CMRCs, ensuring capacity building across the project.
  • Awareness: SAGs work as “peer educators” and engage with different groups of village members to create awareness on the symptoms of TB and availability of public services for TB testing and treatment.
  • House-to-house awareness, screening of household members and health camps: SAGs guided by CMRCs, screen households across ~700 villages, to identify people with symptoms or signs suggestive of TB. Periodic health camps, in collaboration with government health staff are organized at pre-determined locations and are used to create awareness about TB and identify people affected by TB.
  • Screening for presumptive TB cases in waiting areas of public hospitals: trained SAG volunteers are placed in busy public hospitals to identify people who present with signs and symptoms of TB in waiting areas of outpatient departments and guide them for early diagnosis and initiation of treatment.
  • Contact tracing: during their village visits, SAGs screen household contacts of all previously diagnosed and current people affected by TB and encourage them to get tested if they have symptoms.

What do we expect to achieve?

This project will demonstrate how a “women-led” community-based model of TB care, including screening, diagnosis, and treatment, can be both effective and sustainable. More than 500,000 households will be screened, which we project will mean that over 21,000 people with symptoms or signs suggestive of TB will be identified, and 1,500 people will be diagnosed with TB and started on treatment.

The project will also identify 100 women affected by TB to play the role of local TB champions, and more than 500 SAGs as TB advocates in their villages. The SAGs will not only raise awareness about TB within their communities, but also link people who have been diagnosed to the healthcare system. They will also work towards breaking stigma barriers and provide emotional and social support needed to people affected by TB.

 

Partners and funding

WE-END TB is a joint initiative between FIND and MYRADA and is supported by the Stop TB Partnership through TB REACH.