Archive for the ‘Health system’ Category

Better tuberculosis control

Friday, May 8th, 2009

One of the main strategies to control tuberculosis is to find and treat people with active disease. Unfortunately, the case detection rates remain low in many countries. Thus, we need interventions to find and treat sufficient number of patients to control tuberculosis.

We investigated whether involving health extension workers (HEWs: trained community health workers) in tuberculosis control improved smear-positive case detection and treatment success rates in southern Ethiopia.

We carried out a community-randomized trial in southern Ethiopia. Involving community health workers in tuberculosis control improved the case detection and treatment success rates for smear-positive patients and for women in particular.

We think our approach improved service access, and recommend this could be applied in settings with low health service coverage and a shortage of health workers.
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Datiko DG, Lindtjørn B (2009) Health Extension Workers Improve Tuberculosis Case Detection and Treatment Success in Southern Ethiopia: A Community Randomized Trial. PLoS ONE 4(5): e5443. doi:10.1371/journal.pone.0005443

Posted in Health system, Tuberculosis | No Comments »

ART programme and task shifting

Wednesday, April 29th, 2009

The use of antiretroviral drugs, and HIV counselling and testing in Ethiopia has increased in Ethiopia. Dr Degu Dare, who was among the first to start ART at rural hospitals in Ethiopia, is the co-author of a recent paper in PLoS Medicine (1).

Has this expansion of ART affected the performance of other health programmes such as tuberculosis and maternal and child health services is the question they asked.

Very interestingly, the authors document task shifting to the health officers, nurses, and health extension workers, and that this might be responsible for the successes of the ART programme in Ethiopia. However, HIV prevention interventions and management of chronic care patients are lagging behind. This may be because doctors leave the public sector to work for NGOs.
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1. Assefa Y, Jerene D, Lulseged S, Ooms G, Van Damme W (2009) Rapid Scale-Up of Antiretroviral Treatment in Ethiopia: Successes and System-Wide Effects. PLoS Med 6(4): e1000056. doi:10.1371/ journal.pmed.1000056

Posted in ART, Health system | No Comments »