Over the past decade, with support from USAID and other partners, Kazakhstan’s National Tuberculosis (TB) Program has reduced TB incidence in the country by 66 percent, and decreased TB mortality sixfold.
Vera Antipina, a case manager who works with the HIV non-governmental organization (NGO) “Answer” supported by USAID in Kazakhstan’s eastern city of Ust-Kamenogorsk was interested in improving her knowledge and skills on the symptoms of TB and how to effectively refer her clients for TB testing, as needed.
Murat Medetov, the Coordinator of NGO “Sanat Alemi”—the first TB patient organization in Kazakhstan, located in the capital city of Nur-Sultan—works with people at-risk of acquiring TB. Vera and Murat have both contributed to the country’s success in reducing TB incidences through their community outreach work with high-risk populations.
When the COVID-19 pandemic began, they grew concerned as fewer people were seeking medical care; at-risk groups were not getting information on TB; and more TB patients were interrupting their treatment. They feared a backsliding of the hard-earned progress that Kazakhstan had made in TB detection and treatment over the past decade. Yet, they were not sure how to adapt their outreach efforts during the pandemic.
Both Vera and Murat were intrigued in late 2020 when they heard about an online training on how to conduct effective virtual TB outreach and prevention activities, offered by the USAID Eliminating TB in Central Asia activity. The goal of the training was to provide community outreach workers, like Vera and Murat, with resources which allowed them to continue reaching the community with TB information even while social distancing during the pandemic.
Vera wanted to learn how to conduct outreach from afar, “I understand that it is important to work with clients and conduct training, and I knew that this could be done using the internet, but the idea of speaking in front of people on a screen, instead of face-to-face, seemed very strange. I had a lot of questions such as how to build rapport with the audience, or how to facilitate a group discussion.”
In December 2020, the USAID Eliminating TB in Central Asia activity, in partnership with Kazakhstan’s National TB Program, delivered a three-week online training course conducting virtual TB outreach, the first such training course ever conducted in Kazakhstan.
During the training, Vera, Murat, and 21 other specialists from non-profit organizations and government healthcare facilities across the country gained up-to-date skills including how to conduct educational webinars, provide remote treatment adherence counseling to TB patients, and reduce stigma and discrimination associated with TB.
At the beginning of the training course many participants were initially skeptical if a virtual training could effectively substitute an in-person training, and can effectively train people on new knowledge and skills.
Yet, the effectiveness of the training course, despite being held virtually, staved hesitancies about the online model. Throughout the course, participants had homework assignments which enabled them to practice their new skills with clients. Finally each trainee was independently organized and conducted a webinar for people affected by TB.
Vera, Murat, and the other specialists trained during the course have gone on to apply their new skills by conducting online peer support groups and TB education sessions.
Three months after the training provided by USAID, the NGO trainees expanded their gained skills to other NGO representatives and together they screened 8,472 people from at-risk groups, detecting 176 TB patients. In comparison, the three months prior to the training, NGO representatives screened 8,347 persons from at-risk groups, detecting only 25 TB patients. This clearly indicates a significant improvement in outreach among at-risk groups. Based on data collected through The Global Fund to Fight AIDS, Tuberculosis and Malaria project over the same time period, Kazakhstan saw a sevenfold increase in the number of people tested from at-risk groups who received a positive result. This increase is attributed to better identification of and outreach to those who need testing.
Vera and Murat used virtual outreach to identify and refer people for TB testing, resulting in over 60 clients being diagnosed with TB, including two cases with TB and COVID-19 co-infection. They have also trained others on virtual outreach with other community outreach workers, so that they, too, could improve their effectiveness in connecting with people during the COVID-19 pandemic.
Murat organized a training on virtual outreach for his colleagues at Sanat Alemi, an NGO of people affected by TB. Vera has integrated her new skills into training people living with HIV (who are at higher risk of TB infection) and is now developing new materials on HIV and TB prevention to work online with students.
Vera sees virtual engagement between outreach workers and clients as a ‘bridge’ linking the community with the health facilities during the lockdowns experienced in the COVID-19 pandemic. Now empowered with new online communication skills she is confidently able to continue her outreach work with the ultimate goal of decreasing the burden of tuberculosis in Kazakhstan.
About This Story:
Since 2020, the USAID Eliminating TB in Central Asia activity has worked to increase the capacity of more than 500 employees of 17 TB organizations in Kazakhstan, introducing a patient-centered approach to improve the efficiency of TB detection and treatment.
