Operational Handbooks

The first step of counselling is to build a partnership with the patient and, if present, with his/her family. This partnership is the foundation that encourages people not just to participate in health education meetings, but also to engage in all aspects of treatment and care. Developing a trusting and caring environment is needed for this partnership, so that people are more likely to talk about their situation and concerns and receive necessary information. Forming a partnership allows for the sharing of information which is important to the process of counselling.

Communication is best when it is a discussion between the patient and the health-care provider, and not just the health-care provider giving instructions or information to the patient. Good communication skills are very important for the treatment of TB. Not only can good communication help patients to understand the disease and treatment, but it can also help the community to better understand TB and correct misinformation that contributes to stigma (42).

Some important elements of communication needed for health education and counselling are discussed below.

With regard to the rights of patients outlined in the declaration of the rights of people affected by TB (9), the following are particularly pertinent as the guiding principles for patient education and counselling:

This section focuses on a key recommendation on patient care and support by providing health education and counselling on the disease and treatment adherence to TB treatment (15, 16).

To support people with TB during their treatment, health policy-makers and practitioners must appreciate that TB affects all aspects of patients’ lives. A focus on caring for each patient as an individual should underlie all aspects of treatment and care. Overall, the principles for person-centred care and support (described in Section 2) should be followed.

Various digital health products are being used to support different elements of TB programmes, such as electronic health records, direct data transfer from diagnostic systems and eLearning modules on mobile applications (24). Digital adherence technologies fit into the larger landscape of information technologies and are intended to help improve communication between patients and health-care workers (25).

The production and writing of this document, WHO operational handbook on tuberculosis Module 4: Treatment – drug-susceptible tuberculosis treatment, was coordinated by Fuad Mirzayev, with the support of Medea Gegia and Linh Nguyen, under the guidance of Matteo Zignol and the overall direction of Tereza Kasaeva, Director of the World Health Organization (WHO) Global Tuberculosis Programme (WHO/GTB). Significant input to finalize the document was provided by Giovanni Battista Migliori, WHO Collaborating Centre for Tuberculosis and Lung Diseases; Fondazione S.

Socioeconomic problems should be addressed to enable patients and their families to be able to complete TB treatment and reduce the impact that the disease and treatment have on their quality of life. These challenges can be successfully tackled through socioeconomic interventions, such as food baskets or transportation vouchers, that enable patients to complete the treatment and which usually work best when they are adapted to a patient’s specific needs. Some NTPs and health-care providers have used these as enablers – i.e.

Dealing with TB and its treatment can be emotionally devastating for patients and their families. As a result, there is immense distress that affects the quality of life of patients and that may also interfere with the way they follow their treatment.