The Development Aid from People to People (DAPP) says it is implementing innovative strategies to combat tuberculosis in Malawi.
DAPP’s Project Lead Vanessa Phiri said with support from Global Fund via World Vision International, the approach to improving TB case detection involves a combination of active and passive case finding methods.
As Vanessa explains, “DAPP uses active and passive case finding approaches, where trained volunteers screen people door-to-door.”
This is complemented by community sensitization efforts through health talks during community leaders’ meetings, as well as strengthening referral systems by linking presumptive cases to nearby health centers for testing.
According to Phiri, the organization places a strong emphasis on engaging community health workers in TB case finding and referral.
Volunteers are trained on TB symptoms, screening, sputum collection, and referral, and are provided with the necessary tools and regular supervision.
To motivate them, allowances are also offered. She said, “we train volunteers on TB symptoms, screening, sputum collection, and referral, we give them tools and supervise regularly, and motivate them through allowances.”
Despite the successes, DAPP has faced challenges in implementing its community TB interventions. One of the hurdles was delays in sample transportation from non-testing sites due to limited transport.
However, the organization’s mobilizers have been instrumental in bridging this gap, even when it means going beyond their regular schedules.
Stigma is another challenge that DAPP has tackled head-on through community sensitization efforts, involving community leaders, volunteers, and TB survivors who share their success stories.
As Vanessa notes, “stigma is another challenge; we address it through community sensitization with community leaders, volunteers and TB survivors who share their success stories.”
The impact of DAPP’s work is evident in the success stories that have emerged. One notable example is the testimony of a TB patient from Makomano under Makata Health center.
After suffering for a long time without knowing the symptoms of TB, volunteers approached him for a one-on-one health talk, leading to his diagnosis and treatment.
Today, he has fully recovered and is thriving. Phiri shares this story, saying “one TB patient from Makomano under Makata Health center shared his testimony after suffering for a long time without knowing the symptoms of TB, volunteers approached him for a one-on-one health talk, he provided a sputum sample, which tested positive, he immediately started treatment and has since fully recovered.”
To ensure that TB services are accessible to marginalized communities, DAPP works closely with local leaders to gain entry and trust.
These leaders play a crucial role in identifying community TB volunteers, who in turn help mobilize community members, identify presumptive cases, conduct follow-ups, and encourage treatment adherence.
Phiri highlights the importance of this partnership, stating that “we work closely with local leaders to gain entry and trust in communities, and these leaders are the ones who choose community TB volunteers, we also involve TB survivors to build trust and reduce stigma.”
DAPP’s collaboration with stakeholders is also a key aspect of its TB control efforts. The organization works closely with the Ministry of Health, aligning with national TB guidelines and benefiting from training, supervision, and data sharing.
Additionally, DAPP coordinates with other NGOs for joint activities, technical support, and sharing resources. As Phiri notes, “DAPP works closely with the Ministry of Health by aligning with national TB guidelines and also for training, supervision, and data sharing, we coordinate with other NGOs for joint activities, technical support, and sharing resources.”
Looking ahead, DAPP plans to expand its active case finding efforts to more hotspots and explore digital tools for better data collection and follow-up.
According to Vanessa, “based on ongoing monitoring and evaluation we plan to expand active case finding to more hotspots, additionally we are exploring digital tools for better data collection and follow up.”
DAPP is implementing community TB in the southern region under World Vision Malawi. The program will run until June 2027.
