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We present results from nine TB REACH interventions, review the main challenges experienced and formulate recommendations for other early implementers.
These arguments rest on the assumption that all population subgroups benefit equally from broad reach interventions, which is counter to the increasing burden of smoking concentrated in disadvantaged groups.
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Participants were asked about their work (role and motivation), experiences before and after the TB REACH intervention, roles in the TB REACH intervention, opportunities and challenges faced and their perceptions of the strengths and weaknesses of the intervention.
They were however enthusiastic about the work of the TB REACH intervention which had helped to re-motivate some technicians.
In the context of the TB REACH intervention, all health workers felt rewarded in their role in delivering services to vulnerable, remote and rural disadvantaged community groups.
Supervisors, whose time was spent exclusively on the TB REACH intervention, also felt job satisfaction as a result of their part in saving lives and serving the community.
In the context of the TB REACH intervention, health worker reward appeared to have a considerable intrinsic component across the different cadres that motivated them to perform well.
For the Wave 1 control group practitioners, the 9- and 12-month assessments occurred after the practitioners crossed over to the intervention arm and received the CAM Reach intervention.
The relatively high cost of establishing specialist services is almost certainly a deterrent to many countries, which is why the FCTC guidelines urge countries so strongly not to develop such services until lower-cost broader-reach interventions have been established.
While the preference for broad-based programmes may be based on egalitarian principles [ 79], in fact this focus on broad-reach interventions may promote inequality if these interventions are most successful amongst advantaged subgroups.
In the light of the examples given above, the suggested geo-maps may be an additional tool for allocation of necessary resources to dental practitioners to act as health advocates and monitor out-reach interventions performed by auxiliary staff.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com