April 2014 – December 2018
With initial support from the Global Health and Education Trust (GHE) and Otsuka SA, project PROPER CARE (PPM-driven Reinforcement Of Patient Enrolment and Retrieval, Community Advocacy, Reach and Engagement) was launched in April 2014 and sought to increase new case detections and minimize losses to follow-up. The project’s activities are based on three main strategies: 1) active advocacy and case finding, 2) holistic engagement of public and private TB care stakeholders and 3) comprehensive care for patients and their families.
Traditionally, national TB programs have relied on passive case finding to identify patients with TB. Recognizing that early detection and diagnosis of TB is key to reducing the harmful effects of the disease on affected patients and reducing disease transmission to others, PROPER CARE piloted a new approach to case finding by expanding outreach of the existing National TB Program (NTP) services into the community. The pilot project covered Go Vap in Ho Chi Minh City, a district with a population of 650,000 - almost half of whom are internal migrants. In addition to engaging the Go Vap District Health Center and TB Unit, we built a network of 50 private clinics and 200 pharmacies to support with advocacy and health promotion.
In 2015, our active outreach in the community helped increase detection and treatment enrollment by 17.3% to 28.3% compared to the intervention baseline. By providing patient counselling and support, we helped reduce loss to follow-up from 7.0% down to 0.3%.
With compelling early results, FIT received additional funding from Janssen and Johnson & Johnson to expand the geographical reach of PROPER CARE to 2 additional districts. In addition to expanding active case finding activities, the project conducted operational research on the cost-effectiveness of the employee (Go Vap) vs. volunteer (District 8 and Binh Chanh) staffing model measured by cost per new detection. This health economic evaluation generated evidence for assessing the feasibility of a city-wide scale-up of PROPER CARE (read more about the IMPACT-TB and ZTV projects here).
Past sponsors of the project include Global Health and Education Trust (GHE), Otsuka SA, Janssen and Johnson & Johnson, Licata Catering, Emcosys GmbH, Restaurant Quan Van, the many friends of FIT and its members.