International non-governmental organizations (INGOs) have been implementing community-based tuberculosis (TB) care (CBTBC) in Myanmar since 2011. Although the National TB Programme (NTP) ultimately plans to take over CBTBC, there have been no evaluations of the models of care or of the costs of providing CBTBC in Myanmar by INGOs.
This was a descriptive study using routinely-collected programmatic and financial data from 4 INGOs during 2013 and 2014, adjusted for inflation. Data analysis was performed from the provider perspective. Costs for sputum examination were not included as it was provided free of charge by NTP. The authors calculated the average cost per year of each programme and cost per patient completing treatment.
This study revealed a wide variety of models of care and associated costs for implementing CBTBC in diverse and challenging populations and contexts in Myanmar. Consequently, the authors recommend a more comprehensive evaluation, including development of a cost model, to estimate the costs of scaling up CBTBC country-wide, and cost-effectiveness studies, to best inform the NTP as it prepares to takeover CBTBC activities from INGOs. While awaiting evidence from these studies, model of CBTBC that have higher sustainability potential and allocate more resources to patient-centered care should be given priority support.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Han WW, Saw S, Isaakidis P, Khogali M, Reid A, Hoa N, Zaw KK, Aung ST. Different challenges, different approaches and related expenditures of community-based tuberculosis activities by international non-governmental organizations in Myanmar. Infectious diseases of poverty. 2017; 6(1):59.
Different challenges, different approaches and related expenditures of community-based tuberculosis activities by international non-governmental organizations in Myanmar