The Impact of Involving Informal Health Providers for Tuberculosis Control in Sudan
The Impact of Involving Informal Health Providers for Tuberculosis Control in Sudan
Training and engaging of unpaid informal providers (such as tea-sellers, women's groups,
 youth clubs, small traders and religious groups) from poorer localities in TB disease
 recognition, referral and community awareness raising will increase the access of TB patients
 to formal health facilities and decrease their delay in initiating TB treatment.
Barriers to accessing health services faced by poor and vulnerable populations are numerous
 in developing countries. These include; geography, income poverty, lack of trust in the
 quality of public health services, and lack of empowerment of women and adolescent girls (as
 patients and carers) to mobilize adequate and timely resources to access these services.

 The project aims to test if TB case detection can be increased by engaging informal health
 care providers in active case finding. In one urban district of Khartoum, these providers
 will be trained to work as first point of entry to the health system using a comprehensive
 package that includes disease recognition, health communication, and patient referral. In a
 comparator urban district of Khartoum, no attempts will be made to engage informal providers.

 By comparing data of TB patients and Lab registers between the intervention and comparator
 districts in Khartoum, this project aims to test if, and to what extent, these expected
 effects can be realized.

 Overall this is a trial of a health policy so individual patients will not be recruited or
 randomized to one intervention or the other. Rather the policy is being applied in one
 district while the other district is being used as a comparator.
Inclusion Criteria:

 -  Access point for health seeking by the poor and vulnerable

 -  Active and well known in community

 -  Intervention activities can be confined to intervention area

 -  Based in community/locality

 -  Longevity; long standing

 -  Present in control and intervention areas

 -  Able and willing to complete the training to be Triage-Plus providers (ie giving
 formal consent)

 Exclusion Criteria:

 -  Formal health providers, e.g. clinics, labs, hospitals (MOH, NGO or private)

 -  Internationally funded organizations, e.g. international NGOs

 -  Civil servants e.g. teachers