A Situational Analysis of Screening and Treatment of TB in Pregnant Women across 5 Countries

Abstract

Background: Tuberculosis (TB) is the third leading cause of death among women of reproductive age, and undiagnosed TB among pregnant women can result in poor outcomes for both women and their children. Therefore, it is essential for National Tuberculosis Programs (NTPs) to strengthen their policies and guidelines addressing TB in pregnant women and adopt more efficient screening practices. The purpose of this situational analysis is to identify key approaches to addressing TB in pregnancy and to identify barriers and recommendations for the integration of TB and Antenatal Care (ANC) services. Methods: We conducted an initial desk review of the existing literature and recommendations from international organizations on global strategies to address TB among pregnant women. We developed a multi-country survey to gather information on current practices regarding TB screening and treatment among pregnant women as well as barriers to integration of TB services with ANC services. Results: We received survey responses from five countries (Bangladesh, Indonesia, Myanmar, the Philippines, and Vietnam). Only Myanmar had fully integrated TB and ANC services. While respondents from all countries identified the potential benefits of TB/ANC service integration, the most commonly identified barriers to implementation included lack of management capacity to supervise integrated services, inadequate staff, and lack of knowledge about TB among ANC staff. Conclusion: While countries are aware of the advantages and opportunities associated with integrating TB services into other health care services, the implementation of such integration remains a challenge. Integration of services is one of the key recommendations of this study. Where services have been fully integrated, operational research is needed to evaluate its impact.