title: Engaging informal providers in TB control: what is the potential in the implementation of the WHO Stop TB Strategy? A discussion paper.
abstract: The World Health Organization (WHO) Stop TB Strategy calls for involvement of all healthcare providers in tuberculosis (TB) control. There is evidence that many people with TB seek care from informal providers before or after diagnosis, but very little has been done to engage these informal providers. Their involvement is often discussed with regard to DOTS (directly observed treatment - short course), rather than to the implementation of the comprehensive Stop TB Strategy. This paper discusses the potential contribution of informal providers to all components of the WHO Stop TB Strategy, including DOTS, programmatic management of multi-drug-resistant TB (MDR-TB), TB/HIV collaborative activities, health systems strengthening, engaging people with TB and their communities, and enabling research.The conclusion is that with increased stewardship by the national TB program (NTP), informal providers might contribute to implementation of the Stop TB Strategy. NTPs need practical guidelines to set up and scale up initiatives, including tools to assess the implications of these initiatives on complex dimensions like health systems strengthening.
authors.affiliation: Division of Global Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. Bwira.Kaboru@ki.se
authors.forename: Berthollet Bwira
authors.initials: BB
authors.lastname: Kaboru
authors.forename: Mukund
authors.initials: M
authors.lastname: Uplekar
authors.forename: Knut
authors.initials: K
authors.lastname: Lönnroth
mesh_terms: D003299:Cooperative Behavior; D023801:Directly Observed Therapy / Q000379:methods; D014943:Global Health; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control; D006282:Health Personnel / Q000458:organization & administration; D006298:Health Services Administration; D006280:Health Workforce / Q000458:organization & administration; D006801:Humans; D007373:Interinstitutional Relations; D055118:Medication Adherence; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000517:prevention & control; D014944:World Health Organization