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TB Notes 4, 2003


Update on Education and Training Activities in the PARTNERS MDRTB Project

The PARTNERS TB Control Program is a consortium of health organizations brought together by Harvard University and is funded by a grant from the Bill and Melinda Gates Foundation to address the problem of drug-resistant TB in Peru. In addition, the PARTNERS program seeks to create an exportable model for other countries to use in their multidrug-resistant TB (MDRTB) control programs. The program has four objectives:

  1. To demonstrate the success of the project and take it to scale in Peru.
  2. To define the necessary infrastructure and establish it in Peru to sustain a successful integrated program independent of PARTNERS
  3. To articulate the components of a replicable generic model, drawing on lessons from Peru and Russia.
  4. To provide strategies and a demonstration platform to strengthen the global TB control effort

As the PARTNERS MDRTB project closes its third year, significant progress has been made and considerable challenges lie ahead. As the project expands from Lima to the rest of Peru, large numbers of health care personnel must be trained to adequately manage MDRTB patients. Five separate regional training sessions were held all over Peru in the spring of 2003. These sessions were conducted for physicians, nurses, and health promoters who serve as DOTS outreach workers.

Based on the education and training needs assessment that was conducted in spring 2001, many other activities have been developed or planned. Some of the principal findings from the needs assessment: 1) training for HCWs on MDRTB is limited; 2) MDRTB educational materials for HCWs are lacking; 3) MDRTB training needs included knowledge and management of adverse reactions to second-line drugs, management of comorbid conditions, infection control, HCW-patient communication, and patient emotional support; 4) educational MDRTB materials for patients and their families are needed.

An MDRTB clinical management pocket guide for physicians was published in September 2003 to be used as a reference in clinical management of MDRTB and comorbid conditions, as well as adverse reactions. A series of trainings on TB infection control for health care workers has been scheduled for January 2004; these plans include the publication of a training module on infection control. Also in September, the project printed a patient education flipbook for MDRTB, which is designed to be used by health care workers in educating patients about MDRTB and the treatment process. The flipbook can improve provider-patient communication and ensure consistent information is delivered by the health care worker. In addition, health care workers will have a patient education pamphlet with information about MDRTB that can be provided to the MDRTB patients when they leave the health centers. This pamphlet will be printed in January 2004.

These advances and the development of these educational materials have taken place in the midst of a number of personnel changes within the Peruvian Ministry of Health, as well as in other PARTNERS member organizations. The most significant changes have taken place within the Ministry and include changes to the head of the National TB Program, and loss of staff for the TB program as health sector reform takes hold. Also, the Minister of Health of Peru was replaced in July 2003, and with the new Minister will come new personnel in key leadership positions. The work of the PARTNERS project continues to move forward, but the changing faces signify a learning process for the new personnel and a readjustment for all involved.

The project continues to enroll new patients, expands to cover more of Peru, and seeks lessons learned and possible models in order to provide examples for other countries desiring to begin a DOTS-Plus program for the treatment of MDRTB.

—Reported by Jacob Creswell, MPH
Div of TB Elimination


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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