A key example of this is through the way we are engaging and empowering the TB affected community in Daru, Papua New Guinea, through a pilot model of patient education and counselling (PEC) that trains and mentors a team of peer-counsellors or “TB-PALS” (People Affected by, Living with, or having Survived TB) to provide education and counselling to people taking treatment for TB disease and infection, and their families.
This team uses a patient-centred approach to provide psycho-emotional support, facilitate adherence to treatment and promote well-being.
The model of care integrates with facility and community-based delivery systems for both drug-sensitive (DS-TB) and drug-resistant (DR-TB) care and prevention that the Burnet Reducing the Impact of Drug-Resistant TB (RID-TB) project supports.
The pilot model of PEC care initially focused on DR-TB due to the complexity (side effects, length) of this disease and increased impact of social and emotional issues for patients.
It soon became clear that there was also a strong need for education and support for people on treatment for DS-TB and the families of children taking treatment for latent TB infection, and in response the project spread its services across these areas.
Care is provided through standardised education and counselling sessions provided at key points during the treatment journey, supplemented by tailored individual support where required (eg. Treatment interruption follow up, home visits, medication supply counselling).
Additional support is also provided through:
- Family education and counselling offered to each person on treatment
- Referrals to clinical staff and external services where required
- Health education talks provided at busy locations throughout the hospital grounds and at treatment sites
- Facilitation of peer group discussions in the hospital wards and treatment sites to encourage sharing of lived experience and support amongst people on treatment.
- Regular child focused activities at the treatment sites and large scale child patient events every quarter
- Regular peer group activities for young adults on treatment, including a Photovoice program held in early 2019
- Tools and resources for use in provision of counselling and education have been created, trialled and adjusted based on feedback from counsellors and people on treatment.
Current tools and resources include:
- Guidelines for DR-TB, DS-TB and Preventive Therapy standard session counselling
- Flipcharts for DR-TB, DS-TB, Preventive Therapy (Sleeping TB), Bedaquiline and general health education
- Checklist for Supply Request Counselling
- Handout on infection and disease provided in the first session of counselling
- Visual aids for explaining infection, disease and the impact of treatment
- Child-friendly tools: a board game and story book
The tools and resources are currently undergoing an update. For further information or to obtain a copy of any of the above please contact firstname.lastname@example.org
Patient surveys regarding the counselling and education services have resulted in high satisfaction rates, demonstrating the appreciation felt by people on TB treatment for the support provided by the project team.
Feedback from people on treatment and their families, combined with the high treatment completion rate in Daru, show that the project is abiding by its aim of reducing the impact of social and emotional issues on TB patients and their families.
Reduction of the barriers to treatment will ultimately contribute to a reduction in TB transmission in Daru.
- Supported by the Australian Government
- Provincial Health Office, Western Province, PNG, National Department of Health, PNG
- World Vision International
- Health and HIV Implementation Service Provider (HHISP), South Fly District Health Service , PNG
- Daru General Hospital, PNG
Meet the project team. Together, we are translating research into better health, for all.