Center for Executive Education (CEE)


Post Graduate Diploma in Healthcare Management


Dr. Farah Ahmed

Project Type

PGD Project Report

Executive Summary

The World Health Organization (WHO) Directly Observed Treatment Short-course (DOTS) strategy for Tuberculosis (TB) was adopted and piloted in Pakistan from 1995 onwards, but major progress was achieved after the revival of the National TB program (NTP-2001) when TB was declared a national public health emergency through the “Islamabad Declaration”. The NTP under the Ministry of Health and responsible for coordinating, policy direction, and technical guidance, while implementation was the responsibility of the Provincial TB project. TB services are integrated into the primary public healthcare system at the district level with collaboration between the Global Fund and the Government of Sindh. Additionally, significant improvement in case detection and treatment success rates occurred via an improved surveillance and laboratory network with upgraded follow-up and treatment techniques.

Pakistan is the 5th highest TB burden country and by far the largest among 22 of WHO’s Eastern Mediterranean Region. A 5-year plan was devised to universal DOTS coverage in the public sector. It monitored TB control activities with tech support to provincial and district health authorities through professional coordinators and supervise activities at diagnostic hubs. Scaling up multiple drug-resistant tuberculosis (MDR-TB) care is an urgent task for Pakistan due to the increasing annual incidence rate.

Health-Related Quality of Life (HRQOL) is an instrument for monitoring TB patients’ treatment progress. It’s mainly contributed to the government in early detection, treatment success, and breaking the chain of TB transmission. Short Form-36 (SF-36), HRQOL evaluation of TB/MDR-TB patients contain eight scales with a scale score ranging from 0 to 100 (percent of maximum sum score). It covers physical functioning-PF (10 items), role limited due to physical health-PH (4 items), role limited due to emotional problem-EP (3 items), energy-E (4 items), emotional well-being-EW (5 items), social functioning-SF (2 items), pain-P (2 items) and general health (5 items). HRQOL assessments were performed on TB patients during the treatment phase.

In the calculation of eight scales of health domains, mean and standard deviation (Mean+SD) is calculated and reliability tested by Cronbach’s alpha coefficient. The pie chart represents the participant’s gender, bar chart for age with a mean and standard deviation of scales scores, and histograms of all scales.

The Health-related Quality of Life (SF-36) scoring was poor among TB patients during their treatment regime. Our findings indicate the mean scores of emotional well-being, general health, pain, and energy scales have the high mean value, while role limited due to physical health and emotional problem were noticeably the least mean values of all health domains.

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