Tuberculosis-tobacco integration in the South-East Asia Region: policy analysis and implementation framework.

SETTING: Despite overwhelming evidence for the association between tuberculosis (TB) and tobacco use, it remains neglected in the context of policy, planning and practice. There is limited evidence about the extent of integration of TB and tobacco control programmes in South-East Asia Region (SEAR) countries. OBJECTIVE: To assess the level of TB-tobacco integration in 11 SEAR countries. DESIGN: Cross-sectional study using a structured questionnaire addressed to TB and tobacco focal points at the World Health Organization Country Offices. RESULTS: Apart from India, no country in the SEAR has a formal coordination mechanism for national TB and tobacco control programmes or a system of referral for tobacco users among TB patients for treatment of tobacco dependence. There is no joint planning, joint training or joint supervision and monitoring in any country. CONCLUSION: There is poor integration between TB and tobacco control programmes in most SEAR countries. This assessment fed into the development of a regional framework for TB-tobacco integration, which outlines three strategies: 1) integrated patient-centred care and prevention; 2) joint TB tobacco actions covering policy development, planning, training and monitoring; and 3) research and innovation. Every country in the region should adopt the TB-tobacco integration framework to improve programme performance.

Government-NGO collaboration: the case of tuberculosis control in Bangladesh.

This study analyzes the basic concepts and key issues of existing collaboration between government and non-governmental organizations (NGOs) in health care, using as an example the implementation of the DOTS (formerly an abbreviation for directly observed treatment, short course) strategy for tuberculosis (TB) control in Bangladesh. It also examines efforts by the Government of Bangladesh to improve health services delivery, especially for the poor, through collaboration with NGOs. Data were collected in 2001 and 2002 as a part of the process of developing a public-private partnership model for TB care in Bangladesh. Analyses of existing collaboration models in TB control strongly suggest that the government and NGO sectors can be complementary in controlling TB. We found an increasing trend of government collaborating with NGOs in implementing TB control programmes. The study indicates that government-NGO collaboration is an effective way of improving access to and quality of TB and other health care services.