Advocacy, communication and social mobilisation for tuberculosis control in Pakistan: a qualitative case study

Z Haq, W Khan, S Rizwan

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SETTING: A national-level study in four districts, one each in all four provinces of Pakistan, a high tuberculosis (TB) burden country.

OBJECTIVES: To examine how advocacy, communication and social mobilisation (ACSM) campaigns by the National Tuberculosis Programme (NTP) in Pakistan engaged the populations of interest, to what extent they were successful in promoting services and desired behaviours, and how these campaigns could be improved.

DESIGN: This was a qualitative case study comprising 13 focus groups and 36 individual interviews in four districts. All three levels of the ACSM programme, i.e., planners, implementers and beneficiaries, were included among the respondents.

RESULTS: Improved political commitment, availability of funds, partnership with the private sector, visibility of the NTP and access to directly observed treatment (DOT) were achieved. Individual and social environmental issues of poor patients and marginalised communities were addressed to some extent, and could be improved in the future. Empathy and respect from physicians, and better service delivery of the DOTS-based programme were desired by the patients.

CONCLUSIONS: The strategic advocacy ensured political and financial commitment; however, identification and targeting of vulnerable populations, and carrying out context-based social mobilisation and effective counselling are crucial to increase the use of DOT. Evaluations should be built-in from the beginning to increase the evidence on effectiveness of ACSM campaigns.

Original languageEnglish
Pages (from-to)394-399
Number of pages6
JournalThe International Journal of Tuberculosis and Lung Disease
Issue number3
Publication statusPublished - 1 Mar 2013


  • Communicable Disease Control/economics
  • Communication
  • Cooperative Behavior
  • Cost of Illness
  • Focus Groups
  • Health Care Costs
  • Health Services Accessibility
  • Humans
  • Interdisciplinary Communication
  • Interviews as Topic
  • Marketing of Health Services
  • National Health Programs/economics
  • Pakistan/epidemiology
  • Patient Advocacy/economics
  • Physician-Patient Relations
  • Public-Private Sector Partnerships
  • Qualitative Research
  • Social Responsibility
  • Socioeconomic Factors
  • Tuberculosis/diagnosis
  • Vulnerable Populations


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