Projects

RID-TB Patient Education and Counselling

Reducing the Impact of Drug-Resistant Tuberculosis through Patient-centred Education and Counselling (PEC)

TB PALS team in Daru, Papua New Guinea
Image: The TB PALS team and Lead Counsellors, (left to right): Aniba Koivaku, Nazzy Ruhi, Maryanne Hapolo (Lead Counsellor), Allan Kuma (Lead Counsellor),Lucy Dai, Theresia Haihuie (Lead Counsellor), Iru Tofinga, Jenny Bodolo, Desmond Sampson

Burnet’s aim is to accelerate change through interventions that are informed and driven by the local stakeholders and community. We have a major focus on building local health worker capacity and strengthening systems to sustain the response.

A key example of this is through the way we are engaging and empowering the TB affected community in Daru, Papua New Guinea, through a pilot model of patient education and counselling (PEC) that trains and mentors a team of peer-counsellors or “TB-PALS” (People Affected by, Living with, or having Survived TB) to provide education and counselling to people taking treatment for TB disease and infection, and their families.

This team uses a patient-centred approach to provide psycho-emotional support, facilitate adherence to treatment and promote well-being.

The model of care integrates with facility and community-based delivery systems for both drug-sensitive (DS-TB) and drug-resistant (DR-TB) care and prevention that the Burnet Reducing the Impact of Drug-Resistant TB (RID-TB) project supports.

Image: Peer Counsellors are based at the community treatment sites and provide in home counselling and education when requested

The pilot model of PEC care initially focused on DR-TB due to the complexity (side effects, length) of this disease and increased impact of social and emotional issues for patients.

It soon became clear that there was also a strong need for education and support for people on treatment for DS-TB and the families of children taking treatment for latent TB infection, and in response the project spread its services across these areas.

Care is provided through standardised education and counselling sessions provided at key points during the treatment journey, supplemented by tailored individual support where required (eg. Treatment interruption follow up, home visits, medication supply counselling).

Additional support is also provided through:

  • Family education and counselling offered to each person on treatment
  • Referrals to clinical staff and external services where required
  • Health education talks provided at busy locations throughout the hospital grounds and at treatment sites
  • Facilitation of peer group discussions in the hospital wards and treatment sites to encourage sharing of lived experience and support amongst people on treatment.
  • Regular child focused activities at the treatment sites and large scale child patient events every quarter
  • Regular peer group activities for young adults on treatment, including a Photovoice program held in early 2019

Tools and resources for use in provision of counselling and education have been created, trialled and adjusted based on feedback from counsellors and people on treatment.

Current tools and resources include:

  • Guidelines for DR-TB, DS-TB and Preventive Therapy standard session counselling
  • Flipcharts for DR-TB, DS-TB, Preventive Therapy (Sleeping TB), Bedaquiline and general health education
  • Checklist for Supply Request Counselling
  • Handout on infection and disease provided in the first session of counselling
  • Visual aids for explaining infection, disease and the impact of treatment
  • Child-friendly tools: a board game and story book

Guidelines

Flipcharts in use

Board game

Board game helping children understand treatment

Visual aids

Visual aids- boxes showing lungs with TB infection and disease

The tools and resources are currently undergoing an update. For further information or to obtain a copy of any of the above please contact tess.keam@burnet.edu.au

Patient surveys regarding the counselling and education services have resulted in high satisfaction rates, demonstrating the appreciation felt by people on TB treatment for the support provided by the project team.

Feedback from people on treatment and their families, combined with the high treatment completion rate in Daru, show that the project is abiding by its aim of reducing the impact of social and emotional issues on TB patients and their families.

Reduction of the barriers to treatment will ultimately contribute to a reduction in TB transmission in Daru.

TB counselling

Image: Feedback from patients and their families has guided continual adaption and improvement of the project services

Timeline

2016-2020

Collaborators

  • Provincial Health Office, Western Province, PNG
  • National Department of Health, PNG
  • World Vision International
  • Health and HIV Implementation Service Provider (HHISP)
  • South Fly District Health Service , PNG
  • Daru General Hospital, PNG

Funding

Health Issue

Contact Details

For any general enquiries relating to this project, please contact:

James Lawson

PNG Country Program Manager and Program Manager, Health Security

Telephone

+61392822247

Email

james.lawson@burnet.edu.au