Peer group interventions

Community or peer-led measures penetrate better into the intricate layers of key population and facilitate Intensive Case Finding (ICF). Peer group support helps patients deal with challenges that they face during the treatment period. Several Tuberculosis (TB) patients find their treatment period stressful and having a peer to talk to, who has undergone similar challenges, and a doctor or counsellor to answer their questions, helps build confidence and realization that they are not alone in this journey.

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Figure 1: Characteristics of a Peer Group

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Figure 2: Peer group interventions has an influence on the knowledge, attitude, and quality of life of the pulmonary tuberculosis patients

• Peer group intervention is human centered approach as it involves perspectives from the patients and their care givers encouraging them to openly discuss their concerns. Peer group intervention builds collective strength and solidarity among patients attending the group meeting and improve their treatment experience by learning from experience of peers. Talking to others in support groups reduces anxiety, improves self-esteem, and helps members' sense of well-being overall.

• Peers are an underused resource for strengthening TB prevention and cure activities among socially excluded populations. There is a need for further research into the contribution of peers to TB prevention and cure activities, including analyses of economic effectiveness.

Peer group interventions for TB patients are:

• Conducting patient support group meetings where patients and care givers can discuss their concerns and invite other patients who have addressed similar issues in their treatment. Social support from family and friends, helps in patient’s adherence to treatment. Treatment adherence is a key to the completion of TB treatment. The support is part of an external stimulus which can develop a particular behavior in human.

• Peer group members can facilitate linkages to nutrition and other forms of support for TB patients – Patients or caregivers can be linked to support services like counselling, nutrition and social entitlements, either from the NTEP or through other public schemes or community structures.

• Peer group members can help each other by sharing their knowledge to create linkages with the medical support systems – TB patients who develop side effects due to medication, should be linked for medical support during the meetings. Medical Doctor/STS/TBHV/CHO shall provide counselling to patients regarding side effects of the TB treatment and how to address the issues. Members act as role models for each other. Seeing others who are contending with the same adversity and making progress in their lives is inspiring and encouraging.

• Peer group members can facilitate interactions of family members with Medical officer (M.O.)/National TB Elimination Programme  (NTEP) staff – Peer group meetings can be used to counsel the caregivers on how to take care of the patient at home. A support group is a safe place for someone who needs to talk about intensely personal issues, experiences, struggles, and thoughts.

Resources

Guidance document on community engagement under NTEP Central TB Division, MoHFW, GoI September 2021

Operational handbook on Advocacy, Communication & Social Mobilization for RNTCP, Central TB Division, MoHFW, GoI 2014  

NTEP Training Modules 5 to 9, Central TB Division, MoHFW, GoI 2020

Assessment