Tuberculosis and Leprosy Control Programme

This document and an accompanying set of matrices, resulting from a collaborative academic agreement between the national Tuberculosis Control and Prevention Department of the Federal Ministry of Health (TLCP-MOH) of Ethiopia and the University of Brescia and World Health Organization (WHO), is a needs assessment for tuberculosis (TB) control in Ethiopia. It is part of the national level strategic plan on advocacy, communication, and social mobilisation (ACSM) for tuberculosis control. It is a baseline tool document that, according to the author, functioned to facilitate initial discussion for strategy building.

According to the document, the initial step in the Ethiopia needs assessment was to gather "key inputs from... stakeholders who can make changes happen and know the problems at a national level..." and then add stakeholders who are affected or at risk, who care about the issue, and who can influence public opinion and knowledge. The key stakeholders that were consulted included national leadership and experts in TB, national communicators, opinion leaders, health workers, people infected and affected by the disease, and community representatives. Methods, chosen for their strategic utility in providing information in a short time frame, were: rapid assessment and response, social marketing, the Provus Model, finding - situation analysis, community participation and Brazilian educator Paulo Freire‘s theory on the power of participatory dialogue.


Among the evidence and conclusions of the report, the author includes the following communication-related information:

• Evidence shows the crucial importance of advocacy campaigning, and social mobilisation to create awareness about TB, Leprosy and TB/HIV among policy makers, community leaders, religious leaders and the community at large.
• TB experts identified strategic activities including organising a comprehensive proposal to mobilise the community in health education and poverty reduction programmes, especially in low economic status fringes of the population.
• There is a need for strategic communication programmes, including provision of visual materials and printed information, enabling TB regional coordinators & health workers to use practical and cost-effective information, education, and communication tools, kits, and tactics to generate and increase TB awareness aiming at promoting early consultation and diagnosis, to increase active case detection, and participatory activity with broader stakeholder groups.
• Myths, stigma, and TB misunderstandings disclosed by the affected individuals and community at risk need to be addressed in information and educational materials promoted through communicators and social marketing experts at the national level.
• In addition to TB services delivery and communication gaps, there is a need for TB teaching aids such as videos and flip charts to educate TB patients on treatment awareness and to increase social responsibility. Also, for health workers and the wider group of stakeholders involved in TB prevention and treatment, there is a need to provide a "thinking" forum such as a newsletter and magazine.

Matrices provided with the document demonstrate strengths and opportunities, opportunities and weaknesses, and needs for and threats to capacity building among the stakeholder constituencies. These point to a number of communication-related opportunities, among many, including strengthening the capacity of health journalists; increasing social marketing capacity for radio, theatre and the visual arts in community education; including the factors of gender and culture in educational workshops and materials; using participatory methods; and increasing visual teaching materials available to health workers.

In conclusion, the author reviews the dimensions of need found in both the contextual constraints mentioned by health providers interviewed, and in the unmet needs of strategic communication to provide knowledge, skills, abilities and competencies in the field of TB treatment and prevention.

To request a copy of the full paper, please contact the author at the address listed below.