We run a TB Ward at the General Hospital in Port Au Prince. Our patients have many obstacles to maintaing good adherence. Patients are very mobile, often living between different homes in different towns regularly. Others live in temporary tent housing and fear eviction. We keep in contact with our patients (over 1500 since the earthquake in 2010) through phone calls. Patients completing their treatment are given the option to call other patients, to encourage them to take their medications daily. A simple to use computer database creates targetted lists for phone calls, based on concerns regarding compliance. Patients are called for 6 months if infected with TB, indefinitely if infected with TB and HIV. Patients receive a phone call most days.
We chose not to use text messaging as many patients are not comfortable with written language. Having peer support and conversations regarding health concerns has helped many patients make the effort to finish their treatment.

Problema

We could use tablets for data entry, phone minutes from Digicel, payment for workers in the peer adherence network. We need funding for food fo return visits and transport money. Assistance with EMR system (electronic medical records).

Solución

Have patients help each other creating a feel of community and self reliance.

Ejemplo

Patient-led adherence network when DOTS is not feasible for TB compliance.