Our TB Shield model dramatically increases TB screening rates and preventive therapy uptake, especially for children under 5.
We first launched the TB shield model in September 2024 at one of the largest TB hospitals in Pakistan, the Federal Government TB Centre in Rawalpindi, partnering with the Marie Adelaide Leprosy Centre. One year later, we expanded into nineteen more hospitals across seven districts of Sindh.
We're now scaling across all 30 districts of Sindh, working with Sindh's Communicable Disease Control programme through our Pakistani implementation partners, Metrics Research and the Rural Support Programmes Network, with independent monitoring by Momentum.
We are continuing to expand to protect more children from TB.
Before we started our programs, the hospitals had low rates of giving out TB preventative therapy and many did not have services for children.
We designed our TB shield model to:
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Add new community based services and
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Provide capacity building for these hospitals
In Sindh we have also pioneered the use of brand new child-friendly medicine that we helped Pakistan to secure.
The core of the TB shield model is home-based TB screening and TPT provision for under 5 year olds - facilitated by telemedicine.
This means our team of Community Health Officers (CHOs) can screen children for symptoms of TB, get a prescription for TPT and deliver the first month of medicine all in one visit - making it as quick and easy as possible to reach these children.
For those over 5 years old, we provide enhanced facility-based TB screening and TPT provision.
We support the hospital in providing counselling and improved tracking. Our team reach out via phone calls to provide household contacts with the information and encouragement necessary to visit the hospital and get screened for TB.
By reaching people in homes, we have been able to screen almost all under 5s for Tuberculosis:
92%
of under 5s screened in FGTBC
72%
of under 5s screened in Sindh
The field teams are able to counsel households effectively and deliver medicine in the home, meaning:
100%
of eligible children start TB preventative medicine
The child friendly medicine is easy to dissolve, tastes nice and moves children from 6 months of daily pills to a 3-month weekly routine.
For the FGTBC program:
99%
of people who started medicine from Sep 24 - Oct 25, completed their course
We estimate that this program is highly cost-effective, in line with GiveWell's research and its assessment of Spiro.
Program team mixing child friendly formulations of TPT.
