Development of an Integrated Tuberculosis Control System through the Mechanism of the District Health Board, Kham Muang District, Kalasin Province

Abstract

            This study aimed to examine the roles and working processes of the District Quality of Life Development Committee in Kham Muang District in driving integrated tuberculosis control. It analyzed the integration model of digital technology and community participation, evaluated tuberculosis treatment outcomes, and investigated factors related to the success of the Kham Muang TB Control Model. A mixed-methods research approach was employed, collecting quantitative data from the National Tuberculosis Surveillance System, four digital technology systems, and patient medical records, as well as qualitative data from in-depth interviews with 60 key informants, comprising 15 members of the District and Sub-district Quality of Life Development Committees, 25 healthcare personnel, 12 community leaders and network partners, and 8 tuberculosis patients with their families.

            The findings revealed that the Kham Muang District Quality of Life Development Committee played a crucial role in driving tuberculosis control through the integration of a network of 970 village health volunteers and 142 Mr. TB volunteers, covering 71 villages. The KM-TBCM model consisted of six core components: knowledge management, integrated working, treatment and technology, behavior change, community participation, and monitoring and evaluation. Four digital systems—TB Smart Tracking System, KM EPID Program, Clinical Tracer Highlight, and Digital DOT System—reduced working time by 50% and increased reporting speed from 69.57% to 97.15%. Treatment outcomes in 2024 demonstrated a success rate of 92.30%, exceeding the national target, a default rate of 0%, and a mortality rate of 1.54%, which is significantly lower than the national target. The screening of seven risk groups exceeded the average target by 155.2%, with the highest number of patients identified among those aged 60 years and above. Success factors included commitment from local administrators, strong community networks, modern and integrated digital technology, inter-agency integration, supportive national policies, and continuous monitoring and evaluation. The KM-TBCM model demonstrated high effectiveness in tuberculosis control and can serve as a prototype for replication in other areas.