REACH Ethiopia is based in Sidama Zone in the Southern Nations, Nationalities and Peoples Region in collaboration with the TB control programme. The aim is to improve TB case-detection and treatment outcomes in vulnerable groups, particularly women, children, the elderly and disabled. This is a community-based approach that has engaged locally deployed female Health Extension Workers (HEWs). The HEWs are employees of the Ministry of Health, live in the villages where they work, and are thus part of and accepted by the community and familiar with the local culture.
In year 1 HEWs working in 524 villages and over 300 staff from health facilities were trained. Individuals with symptoms of TB are identified by HEWs through house-to-house visits and outreach activities, they collect sputum, prepare smears and liaise with supervisors using mobile phones. One supervisor with a motorbike is deployed in each of the districts to collect and submit slides to laboratories and feedback results, initiate treatment for smear-positive cases in their residence and screen contacts. In year 2 the diagnostic process is being strengthened by introducing LED Fluorescent microscopes and the automated nucleic acid test (Xpert® MTB/RIF) for smear-negative patients with a high risk of having active TB (such as HIV co-infected individuals and children). In year 3 the intervention is being scaled up to cover a much larger population of 7 million. The innovative community-based approach is supported by key stakeholders in the region; it brings services closer to communities and in year 1 smear-positive case notification almost doubled.
Additional information regarding REACH Ethiopia’s work can be found at: