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An innovative primary health care (PHC) project was recently developed
in a high tuberculosis (TB) prevalence, rural area of the Western Cape. The
project consisted of a strategy to introduce community based health care
onto farms by training selected farm workers to work as community health workers
(CHWs). As TB is a priority health problem in the area, the programme emphased
strategies for TB case detection and case-holding.
The pilot project was evaluated by the Medical Research Council during
1996. It was described as a well designed, expertly managed primary health
care intervention which significantly improved treatment outcomes. Dick J,
Clarke M, Tibbs, J. Combating tuberculosis – lessons learnt from a rural
community project in the Klein Drakenstein area of the Western Cape. S Afr
Med J 1997; 87: 1042-1047. The health services are keen to replicate the
model in the Winelands Health District and need to ascertain whether the
intervention will be a cost-effective. This proposal is designed to evaluate
the effectiveness of the intervention on TB case detection, caseholding and
cure rates.
An independent economic evaluation will be undertaken by the South African
Network for Economic Research in order to assess the costs, savings and benefits
of the intervention compared to existing practices.
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