LITTLE DOCTORS CLUB / SCHOOL TB CLUBS PROGRAM

An ACSM intervention funded by GFATM-R6 & implemented by Integrated Health Services (IHS Pakistan)

Introduction:

The “Little doctors club / Schools TB Clubs Program”, funded by GFATM, is an innovative pilot intervention being carried out for the first time as part of Round six of The Global Fund. This program envisions involving school children as ambassadors / messengers of TB, in spreading awareness about the disease among their class mates, school, home and the community as a whole. The awareness thus created aims to enhance the case detection & treatment success rates in the targeted communities / areas.

Agencies Involved:

Funding Agency:  

The Global Fund for Aids, TB & Malaria (GFATM), an international organization created to finance a dramatic turn-around in the fight against AIDS, tuberculosis and malaria is providing complete funding for this program.

Principal Recipient: 

Mercy Corps, an international humanitarian organization is the principal recipient (PR) of GFATM and is the supervising agency for this program.

Implementing Agency (SR):

Integrated Health Services (IHS Pakistan) is a national healthcare organization working in the curative, preventive, research and consultancy sector since 1996 in Pakistan. IHS is operating the largest school health network in Pakistan. IHS is implementing this project as Sub Recipient (SR).

Service Delivery Area:

Social Mobilization:

Building consensus and commitment. The aim is to empower people with TB and communities (ACSM). Goal is to reduce the burden of TB in Pakistan by 2015 in line with the Millennium Development Goals and the Stop TB Partnership targets.

Brief Project Description:

The aim of this project is to establish “The Little doctors clubs” / “School TB Clubs” in 50 schools in 10 selected districts (05 schools per district) in one year. Minimum 500 students in each of these schools will be receiving awareness about TB through lecture sessions, info literatures, poster / calendars, banners and a painting competition on a TB related theme (TB is curable).

“The Little doctors club”/”School TB Clubs” are established in each of the selected schools under supervision of a school teacher. These clubs will act as small advocacy units for these schools and surrounding area / community. Up to 30 students (6%) of each school become ‘founder members’ of the “The Little doctors clubs” / “School TB Clubs”.  The members act as “Ambassadors of TB and/or TB Advocates” and are assigned the task of spreading the information about TB in their school / community.

Some of the figures of the program are mentioned below:

Project Duration:

This is a two year project, extendable to 5 years, starting from 5th October 2007. The first year has been successfully completed. Activities will be same in both years. However, every year, 05 new schools will be added in each district. The program may be upgraded if found successful to include more districts and increase the number of schools as well.

Objectives of the Program:

Project Management:

The project is being managed by an eight member team comprising of the following:

• Project Coordinator - One
• Team Leader – One
• Facilitators - Three
• Support staff - One
• Office Assistant - One
• Driver – One

Project Coordinator is the head of the program, based in Islamabad.

This intervention is dependent on the school’s academic calendar. Therefore, two teams work simultaneously in order to complete the activities in the stipulated period. One team with the team leader and a facilitator covers 05 districts while for the rest of the five districts, two facilitators are deputed, one of them being a senior facilitator.

PROJECT DETAILS:

In the first year, 50 schools were selected in 10 districts (05 in each district) where these project activities were carried out. The districts selected are those where already ACSM component is being implemented by partner agencies. These districts are spread all across Pakistan and include the following:

• Quetta (Balochistan)
• Tando Allah Yar (Sindh)
• Tando Mohd. Khan (Sindh)
• Mandi Bahaudin (Punjab)
• Khushab (Punjab)
• Gujrat (Punjab)
• Sialkot (Punjab)
• Narowal (Punjab)
• Bagh (AJK)
• Muzzafabad (AJK)

Program Material:

The material used during the program is developed during the first quarter of each year in consultation with the PR and NTP.

It includes the following:

Banners for schools with TB punch lines:

04 pena-flex banners for each school. These banners are affixed permanently at the school. Each banner carries a different standardized message about TB.

TB awareness leaflet for school children:

Quantity printed is 25000 every year.  A quantity of 500 is distributed in each school after the interactive session on TB. This leaflet also includes a consent form for becoming a member of TB club. Children are encouraged to get it signed from parents. Aim is to ensure the delivery of TB messages to 25000 house hold.

TB calendar with TB related messages:

Quantity printed is 25000 every year. Each of 500 students attending the school session receives a Poster / calendar with standardized TB messages.

Awareness lecture regarding TB and this project for school children:

These sessions are conducted at the school with multimedia aids by the field teams. Each session has minimum 500 students. In some schools, multiple sessions are held due to space constraints, in order to ensure that a minimum of 500 students are sensitized about TB.

Poster competition is announced during the school session:

Students are advised to prepare posters on TB theme, with material of their choice. These posters are collected from each school 2-4 months later during the first biannual meeting of Tb club. 03 winners are selected by the school management. These winners receive a shield and a certificate during the second biannual meeting, which is held in last qtr every year.

Training of “The Little doctors clubs” / “School TB clubs” members:

A 5-6 page document laying out the objectives, constitution, activities, etc.

Two  training sessions of selected club members are held, to be delivered by the field teams followed by question/answer session

Additionally, all club members receive: 

• Membership forms for TB clubs
• Activity reporting forms / register for club members
• Monthly meeting report forms for TB clubs
• School bags for TB club members with TB punch lines: ( @ 30 per school)
• TB Club badges. ( @ 30 per school)
• Volunteer enrollment forms

Activity Details:

Schools are selected based on following criteria:

• 5 schools from each district.
• Only Middle and / or High schools are selected.
• Combined strength of students in the 5 schools should be 2500. The minimum number of students per school be 500 while the maximum can be 1000.
• 50% or more schools / students are female. Last year, 27 female schools were included in the project, out of 50 schools.
• All the 5 selected schools in a district are preferably within the same area / halqa / union council so that effectiveness of the intervention can be gauged. This is finalized with the help of District education dept officials.
• In each school at least one (or 2) teachers are nominated as in-charge of the TB Club and the focal person for coordination with the program team besides he/she will also be responsible for the monthly reporting of the club members activities.

The Field Teams visit the districts according to a pre-planned schedule keeping in view the school academic calendar of different regions. A letter with brief intro, is send to the concerned departments in respective districts.

Upon reaching a particular district, the team contacts the district education office and finalizes the selection of schools and schedule for school activities. District Health authorities are also kept informed, specially the EDO Health and DTC.

What is done at Schools?

The following is an outline of the specific activities carried out at each school by the field team.

Day 1:        

• Meeting with principal
• Display of banners\

Day 2:

• Multimedia presentation to 500 students and teachers on TB     awareness
• Distribution of 500 Awareness Leaflet/ consent forms for TB
• Club  membership
• Distribution of 500 Posters / calendars with standardized TB     messages.
• Announcement of Poster competition
• Announcement for the formation of TB clubs, inviting students to become members (6% of the total school enrolment)

Day 3:        

•  Screening / selection / Training of TB club Members

Day 4:

• Training of TB club members

Day 5:

• Revision of TB facts with club members, Distribution of bags, badges and stationary among TB Club Members.

The Lecture and training of TB club members is conducted through multimedia aids and interactive sessions by the IHS TB Clubs project team. Total duration of training is 2 hrs on day 04 and a revision is done on last day.

Monitoring & Evaluation:

M&E of the project is responsibility of the Project Coordinator. This is done at three levels:

Primary records:

• “Activity completion Report” signed and stamped by the School Principal from each school.
• “Activity completion Report” countersigned by the EDO (Education) or other officials from each district.
• “Membership forms” of all School TB club members ( @ 30 members / school)
• “Attendance sheets” of training to all School TB club members ( @ 30 members / school)
• “Membership Form” duly signed, of all 50 teachers, designated as School TB Club In Charge.

Photographic Records:

All activities are photographed by digital cameras and later sorted and captioned.

M&E Visits:

Project Coordinator visits the different schools while activities are taking place and also sometimes after the activities have been completed. He meets principals, teachers and students and confirms the activities

Additionally, all data of schools and club members is also entered in a data base along with some other info like poster competition winners and volunteers etc.

School TB Health Clubs:

Constitution of a School TB Health Club

Objectives / Responsibilities of the School TB Health Club

This project will offer many benefits that will ensure better educational outcomes, increase the efficacy of other investments in child development, and will develop Links..... with resources of health and education. This can lead to a long term school health intervention that can be carried on for next five to seven years, subject to successful completion of the program’s first two years.