Tuberculosis (TB) has been a major public health concern for Bangladesh for decades. According to the World Health Organization (WHO), Bangladesh ranksseventhamong the 22 highest TB-burdened countries. BRAC initiated the tuberculosis control programme in 1984 in one district as a pilot. In 1994, BRAC became the first NGO in the country to sign a memorandum of understanding with the government to expand directly observed treatment short course (DOTS) services across the country. BRAC also became a principle recipient (PR) of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), along with the government. The aim of the programmeis to reduce the morbidity, mortality and transmission of TB until it is no longer a public health problem.
BRAC's shasthyashebikas(frontline community health worker) play a pivotal role inconnecting individuals with TB control services during household visits and health forums. They disseminate TB-specific messages to the community, identify presumptive TB patients and refer them, for sputum examination, to the governmen tsub-district health complex or peripheral laboratories of BRAC. The frontline health workers also ensure regular intake of medicine for identified TB patients through DOTS. They refer complicated TB patients to health facilities for further treatment and for proper management of side effects and other complications during TB treatment.
BRAC's approach towards the diagnosis and treatment of TB focuses on community level education and engagement. The programme conducts orientation with different stakeholders of the community to engage them in efforts to identify TB patients, ensure treatment adherence, and reduce stigma surrounding TB. The stakeholders include cured TB patients, local religious leaders, school going children, girls' guides and scouts, other NGO workers, formal and non-formal care providers like graduate private practitioners, village doctors and pharmacists.
Currently, BRAC covers 297 sub-districts from 42 districts, 7 city corporations with a population of 92.9 million people including 31 academic institutes, 41 prisons, 405 peripheral laboratories and 26 external quality assessment centres. BRAC is leading a group of 42 local NGOs who are the sub -recipients (SRs) of the GFATM under the same umbrella of NTP. BRAC supervises, monitors, guides and provides technical assistance to the SRs,to ensure that the quality of the service delivered is uncompromised.