/ AAS -District Program Coordinator role- solving a challenge and to implementing change or reform
How have you contributed to solving a challenge and to implementing change or reform?
Be specific and include:
- What aspect/s of your leadership knowledge, skills and practice you consider to be well established and effective?
- Which people or organizations you worked with to solve the problem?
- What creative methods were used?
One of the essays for Australia Awards Scholarship
IMPROVING TUBERCULOSIS CASE DETECTION AND TREATMENT
Being a public health professional, I wholeheartedly believe that positive change in the community is possible. To achieve this change is not about what you do or who you are but about your true commitment and solidarity with local communities.
In my role as district program coordinator (DPC) for Birat Nepal Medical Trust (BNMT, bnmt.org.np), I have built an extensive collaboration with Nepalese government officials, local authorities, and key stakeholders. Also, the strong community engagement particularly in vulnerable settings has fulfill my dream of working with hard to reach communities to improve their health, including through TB case detection.
Despite having larger numbers of migrant workers, homeless people, and the vulnerable indigenous Chepang people, the TB program in Chitwan district of Nepal which I support (population 700,000) has a high proportion of missed TB cases. Tuberculosis in the district span across these populations. This means vulnerable people with TB never come to seek healthcare because of lack of awareness, education, or money. To address these challenges, I coordinated with local management committees of the metropolitan office to connect with laborers and homeless people. I proactively designed contact tracing plan and deployed additional field staff to provide enhanced support to these groups outside of normal work hours. We also worked with local communities and healthcare facilities to try and coordinate visits to reach the Chepang communities who live in remote areas. With the help of proactive field staff, we increased TB case notification by 22% and managed to meet the district and WHO's target.
This was not an easy task to achieve due to length of TB treatment duration, not adequately trained health workers, poor counseling and support, and poverty and under-nutrition. I cannot see the certain situation and leave it thinking it is normal. To further improve not just TB case detection but also adherence to TB treatment, I worked with local and regional groups to provide people with TB with a pillbox, which carried two weeks' worth of medicines to their home, enhanced frequency of supervisory visits, and conscientiously formalised recording and reporting of patients' progress.
Finally, my technical ability and determination to take part in TB review meetings led me to a position in which I performed accurate and reliable TB data analysis, which was fed back to the national program. In essence, we are continuously supporting the government's initiatives and strategies to improve the health status of the country.