Lessons Learned from the Design and Implementation of the Tuberculosis Free Nepal Initiative.
| Title: | Lessons Learned from the Design and Implementation of the Tuberculosis Free Nepal Initiative. |
|---|---|
| Authors: | Shrestha P; National Tuberculosis Control Centre, Naya Thimi, Bhaktapur, Nepal.; Mishra G; Nayathimi, Bhaktapur.; Khanal MN; National Tuberculosis Control Centre, Naya Thimi, Bhaktapur, Nepal.; Shah NP; National Tuberculosis Control Centre, Naya Thimi, Bhaktapur, Nepal.; Dahal D; National Tuberculosis Control Centre, Naya Thimi, Bhaktapur, Nepal.; Thapa B; World Health Organization, Pulchowk, Lalitpur, Nepal.; Joshi LR; Save the Children International, Nepal.; Ghimire N; Nepal Health Research Council, Ramshahpath, Kathmandu.; Wingfield T; Departments of Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Pembroke Place Liverpool L3 5QA UK; WHO Collaborating Centre in TB and Social Medicine, Karolinksa Institutet, Sweden, Norrbackagatan 4, 171 76; Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8YE, UK. |
| Source: | JNMA; journal of the Nepal Medical Association [JNMA J Nepal Med Assoc] 2025 May; Vol. 63 (285), pp. 369-374. Date of Electronic Publication: 2025 May 31. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Nepal Medical Association Country of Publication: Nepal NLM ID: 0045233 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1815-672X (Electronic) Linking ISSN: 00282715 NLM ISO Abbreviation: JNMA J Nepal Med Assoc Subsets: MEDLINE |
| Imprint Name(s): | Publication: Kathmandu : Nepal Medical Association; Original Publication: [Kathmandu, 1963?]- |
| MeSH Terms: | Tuberculosis*/prevention & control ; Tuberculosis*/epidemiology ; Tuberculosis*/diagnosis ; Tuberculosis, Pulmonary*/prevention & control ; Tuberculosis, Pulmonary*/diagnosis ; Tuberculosis, Pulmonary*/epidemiology; Nepal/epidemiology ; Humans ; Mass Screening ; Program Evaluation ; Community Participation |
| Abstract: | Introduction: Nepal has a persistently high burden of tuberculosis. Despite implementation of multiple interventions by the National tuberculosis Program, Nepal is not on track to achieve many of WHO's End tuberculosis Strategy targets.; Methods: The National tuberculosis Control Centre developed a Google Sheet with key indicators to monitor the tuberculosis -Free Initiative across municipalities. Focal points recorded real-time data, ensuring transparency. National tuberculosis Control Centre compiled, analyzed, and interpreted the data to track progress, evaluate program outcomes, and support future planning.; Results: The tuberculosis-Free Initiative achieved significant results in implementing municipalities. A total of 112 END TUBERCULOSIS Committees were formed at the municipal level, with over 1,000 ward-level committees engaged in tuberculosis microplanning. More than 56% of municipalities mobilized community-led monitoring groups, and 16 municipalities conducted annual social audits. tuberculosis-Free Volunteers facilitated screening in 53 municipalities. In 2023, innovative case-finding methods contributed significantly. The sputum courier system identified 1,790 Pulmonary bacteriologically confirmed tuberculosis cases, 554 cases were diagnosed via screening camps and door-to-door visits, and 222 cases through Primary healthcare centre Outreach Clinics. Additionally, 23 patient support groups, 32 youth groups, and 32 civil society organizations were mobilized, strengthening community participation. These efforts highlight the tuberculosis-Free Initiative's impact on enhancing case detection, community engagement, and tuberculosis control strategies.; Conclusions: Developing local level ownership and accountability in the national tuberculosis response, ensuring high quality implementation through robust monitoring and evaluation, and generating and sustaining local resources, requires strong government leadership, advocacy, and capacity building. Within the implementing teams by the stakeholders, frequent initiative reviews, coaching, and mentoring support.; (© The Author(s) 2025.) |
| Competing Interests: | None |
| Contributed Indexing: | Keywords: directly observed treatment short-course; end tuberculosis; microplanning; tuberculosis; tuberculosis free |
| Entry Date(s): | Date Created: 20260302 Date Completed: 20260308 Latest Revision: 20260308 |
| Update Code: | 20260308 |
| PubMed Central ID: | PMC12831835 |
| DOI: | 10.31729/jnma.8988 |
| PMID: | 41766830 |
| Database: | MEDLINE |
Journal Article