title: Advocacy, communication and social mobilisation for tuberculosis control in Pakistan: a qualitative case study.
abstract: METHODS
  A national-level study in four districts, one each in all four provinces of Pakistan, a high tuberculosis (TB) burden country.
  
  
  OBJECTIVE
  To examine how advocacy, communication and social mobilisation (ACSM) campaigns by the National Tuberculosis Programme (NTP) in Pakistan  engaged the populations of interest, to what extent they were successful in promoting services and desired behaviours, and how these campaigns could be improved.
  
  
  METHODS
  This was a qualitative case study comprising 13 focus groups and 36 individual interviews in four districts. All three  levels of the ACSM programme, i.e., planners, implementers and beneficiaries, were included among the respondents.
  
  
  RESULTS
  Improved political commitment, availability of funds, partnership with the private sector, visibility of the NTP and access to directly observed treatment (DOT) were  achieved. Individual and social environmental issues of poor patients and marginalised communities were addressed to some extent, and could be improved in the future. Empathy and respect from physicians, and better service delivery of the DOTS-based programme were desired by the patients.
  
  
  CONCLUSIONS
  The strategic advocacy ensured political and financial commitment; however, identification and targeting of vulnerable populations, and carrying out context-based social mobilisation and effective counselling are crucial to increase the use of DOT. Evaluations should be built-in from the beginning  to increase the evidence on effectiveness of ACSM campaigns.
authors: Arnold School of Public Health, University of South Carolina, Columbia, South Carolina 29208, USA. drzaeem@hotmail.com
authors: Z
authors: Z
authors: Haq
authors: W
authors: W
authors: Khan
authors: S
authors: S
authors: Rizwan
mesh_terms: D003140:Communicable Disease Control / Q000191:economics / Q000458:organization & administration*; D003142:Communication; D003299:Cooperative Behavior; D017281:Cost of Illness; D017144:Focus Groups; D017048:Health Care Costs; D006297:Health Services Accessibility; D006801:Humans; D033183:Interdisciplinary Communication; D007407:Interviews as Topic; D008389:Marketing of Health Services; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D010154:Pakistan / Q000453:epidemiology; D010344:Patient Advocacy / Q000191:economics; D010817:Physician-Patient Relations; D055818:Public-Private Sector Partnerships; D036301:Qualitative Research; D012941:Social Responsibility; D012959:Socioeconomic Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D035862:Vulnerable Populations