Advocacy, communication, and social mobilization (ACSM) has been identified by WHO as a critical component of effective control of TB and leprosy. The MOHCDGEC is committed to integrating ACSM into health planning and programming. ACSM has three distinct sets of activities which have the shared goal of bringing about behavioural change:
- Advocacy: Primarily works to change the behaviour of public leaders or decision-makers.
- Communication: Generally, targets individuals or small groups in the public.
- Social mobilization: Aims to secure community-based support.
Interventions under one area may beneficially influence or facilitate processes in the other areas. ACSM complements the health system in achieving TB and leprosy control through empowering communities, garnering political and financial support, and addressing the challenges of individual and social behavioural changes. These challenges include:
- Delayed health-seeking behaviour.
- Inadequate access to TB and leprosy diagnostic health facilities.
- Inadequate knowledge of TB and leprosy symptoms and signs.
- Stigma and discrimination.
- Misconceptions and myths surrounding TB and leprosy.
- Poor adherence to TB and leprosy treatment.
- Insufficient resource allocation to TB and leprosy control.
The MOHCDGEC is implementing a National Strategy for Coordinated Response to Tuberculosis and leprosy, which will guide implementation of ACSM in TB & Leprosy interventions in the country. The strategy outlines the following five-point framework for ACSM action to ensure that health care workers, decisionmakers, and communities are engaged effectively:
- Improving case detection and treatment.
- Combating stigma.
- Empowering people affected by TB, MDR TB, TB/HIV and leprosy
- Mobilizing resources from the community.
- Advocating for political commitment and leadership.
ACSM activities
Advocacy:
- Conduct of national advocacy meetings with top ministry management.
- Conduct of advocacy meetings with top regional and district political staff and decision-makers.
- Identification of potential international and local partners.
- Conduct of advocacy meetings with potential stakeholders for resource mobilization.
- Enforcement of implementation of TB/HIV policy at the national, regional, and district levels.
- Identification of community groups for partnership in TB/HIV control.
- Conduct of quarterly follow-up visits to remedy identified gaps in implementing advocacy activities.
Communication:
- Conduct training of program staff and health care providers on effective communication.
- Regular supportive supervision and mentorship in communication.
- Training of school teachers to teach pupils and students about TB and TB/HIV.
- Involvement of media in panel discussions, television documentaries, and radio and television spots.
- Orientation of media staff in TB and HIV care and control.
- Printing and distributing of information, education, and communication materials for TB and HIV care and control.
- Documentation of best practices.
- Conduct of monthly, quarterly, and annual meetings for information-sharing.
- Conduct of regular supportive and mentorship visits.
Social mobilization:
- Conduct of sensitization meetings to influential people and the community at large to reduce stigma among TB and TB/HIV patients.
- Conduct of resource mobilization meetings for influential people and community leaders.
- Training of community’s own resource persons in identification and referral of TB suspects to health facilities.
- Formation of TB and TB/HIV care and control clubs.
