Objectives

	To provide better TB treatment monitoring to at least 1,500 TB patients, including those co-infected with HIV, every year
	Meet and exceed WHO target of 85% treatment completion and cure rates for TB patients registered with the project by the end of year
	To improve levels of awareness and knowledge about TB amongst 1,500 TB patients, 1,100 local volunteers, 2,500 other stakeholders, and at least 10% of the wider population of 1.9 million people in Virudhunagar district through extensive health education activities every year

Bench Mark Survey

This survey was conducted by the project team. It helped us to assess and appraise our performance in the preceding year by observing the level of goal achievement and the diversions made. From here we could see which areas had to be given more attention.  This survey also helped us to know the situation of the health care service providers in relation to the surrounding local communities, as well as formulate the plans and methodology for the implementation for an improved CEPT project.

Edu-clowns Campaigns in the target villages (LEFT) & Mobile Exhibition/Booth Display (RIGHT).

Twenty-two Edu-Clowns Campaigns were enacted in different areas. Around 37,322 people saw the performances and were able to gain awareness about HIV/AIDS.  The Edu-Clowns are known to be an effective method of reaching out to the public, who gave their feedback.  The integration of Edu-clowns theatre drama, Mobile Booth and Exhibition enhanced the effectiveness of the overall Campaign.  The campaigns led to an increase in inquiries, which was followed up by the Community Organizers, and the Coordinator.

Live Telecast Cable TV programme

TV programmes are an effective method of using mass media for propagating TB/DOTS messages to the public, by interacting with them personally at their doorsteps.  More than 1,20,000 people  have been reached. After the programme, our community organizers have become well known to the people in their field, which helped them to move easily throughout the community.  People mingle and are easily able to share their health problems with the community organizers.

Observation of World TB day

BLOSSOM CEPT project observed World TB Day on 24.03.2009 in all Government Hospitals and Primary Health Centres (11 Blocks).  The participants included the CEPT Project Director, Coordinator, Community Organizers, self interested social workers, cured people from TB and the government sector health workers.

Banners and Boards with slogans and messages representing TB Day were displayed in many important places such as the Railway Junction, Bus stand, and Government hospital entrance.

Two persons cured from TB came forward as “Positive Speakers” and talked about the TB treatment process and the CEPT project activities. They explaiined that they are able to go to work, mingle with society, and are happy.  TB patients distributed posters and notices. Through IEC materials we created awareness to the public on TB IS NOT A HEREDATORY DISEASE. The programme was able to reach 25,000 people, raising their awareness of TB and DOTS free of cost.  Community Organisers recorded the meetings in the Government Hospitals from the Doctors, and showed their thanks and support to BLOSSOM Trust.

Sensitization Meetings for different stake holders

During this one year period, 352 meetings were conducted to sensitize different kinds of stakeholders. As a result, 12,279 persons were sensitized to TB/DOTS messages during meetings held in government health centres, panchayat buildings, temples and in the animators houses.  Due to the innovative methods used in our CEPT programme, we are also able to reach illiterate people. Meetings were held by our Community organizers, Coordinator and Director, jointly with the local TB officials and workers in the rural and urban areas, helping to strengthen ties with the government sector as well as generate awareness amongst the public.  A definite change has been seen in the rapport with our stakeholders which has facilitated the implementation process of the CEPT project.  There has been an increase in the number of TB positive persons identified, better services from the Government hospitals and Primary Health centres, and an increase in DOTS Providers and unpaid volunteers.

Self Care Training to TB/DOTS Patients / FATB

During one year period, Self Care Training meetings were conducted for the TB/ DOTS patients and their familes. 71 trainings were conducted and 1229 members were trained. These were conducted jointly with the local VHN’s, AWW’s, STS’s (in some cases the Medical officers were also involved) and were organized by our Coordinator and the concerned Community organizers. The meetings are effective: the spread of TB is mostly curbed among the family members due to timely and personal clarification on the concept; the participants are informed on real facts and how to control the spread to others; and the preparation of low cost nutrition food.

Key lessons learnt

• Many people still do not know about TB/DOTS, emphasizing the need for education and awareness on the subject.
• More intensive efforts such as sensitization programmes, awareness, and knowledge gaining activities must to be conducted among all the health care service providers to improve their services.
• There are still myths and misconceptions about TB /DOTS among the public, which hinders the success of the project in some areas.
• The community organizers find it difficult to collect evidence for new cases, as there are no Xerox machines available in their local area. Many patients misplace or lose their medical reports, adding to the challenge of recording and documenting a new case.
• Unpaid volunteer services were very useful to our project.  In one instance, in Inakkaneri village in the Narigudi block, a 5-year old child ate jetropa seeds.  When the child started vomiting, the village people did not know what to do.  Our unpaid volunteer contacted our community organizer, who was able to contact the Government Doctor.  The child was admitted to the Government hospital and given the appropriate medical attention.
• When community organizers conduct meetings, the unpaid volunteers are involved, building a good rapport with TB patients and their families.  Patients are then able to share their health and family problems with our team. They treat us as one of their family members, strengthening our relationship with the Government hospital staff.   Our community organizers are able to retrieve defaulted cases, which is very helpful for the Government RNTCP team.

Positive aspects

• A proper and definite change is seen among the TB patients and DOTS providers.
• Our staff team, including paid and unpaid volunteers, has a thorough knowledge about TB.
• Our community organizers participate in VHN’s meeting in all blocks, informing the population of our project objectives, activities and support services.
• To get the attention of elite persons, we concentrate on wide and continuous publicity in daily newspapers and magazines.
• We created a platform for the Cured and Non-cured TB patients to express and vent their thoughts, ideas, and opinions in a common forum formed at the block level.

The overall perception the MEET team is the following  (Monitoring, Evaluation and Exposure Team)

	The CEPT programme is reaching the grass roots level in rural areas
	The relationship between our project team and the health care service providers is stronger than at the headquarters level. Efforts should be made to strengthen the latter.
	Importance should be given to more press coverage and publicity for our CEPT project.
	Resources are needed for the existing staff team such as mobile phone and vehicles.
	Public support has increased for the programme.