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The Cough‐to‐Cure (C2C) Guide to Counseling This booklet was made in collaboration with the Philippine Department of Health and with the support of the American People through the United States Agency for International Development (USAID). The contents of this booklet do not necessarily reflect the views of USAID or the United States Government.

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A guide to prevent Tuberculosis transmission

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  • The

    CoughtoCure(C2C)

    GuidetoCounseling

    ThisbookletwasmadeincollaborationwiththePhilippineDepartmentofHealthandwiththesupportoftheAmericanPeoplethroughtheUnitedStatesAgencyforInternationalDevelopment(USAID).ThecontentsofthisbookletdonotnecessarilyreflecttheviewsofUSAIDortheUnitedStatesGovernment.

  • Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations.

    Recognizingandacceptingearlysignsandsymptoms

    Getacquaintedandbuildrelationshipwithnewclient.Assureconfidentiality.Outcome:Icantrustthehealthprovider.

    Askaboutclientssymptomsandhowhe/shefeelsaboutTBandTBcare.Outcome:Icanbeopenwithmyhealthprovideraboutmysymptoms.

    GiveclientaccurateandpersonalizedinformationonTBandhowitcanbecured.Outcome:IbelievewhatmyhealthproviderissayingaboutTB.

    HelpclientdecidetoseeksputumexaminationtodiagnoseTB.Outcome:IwillhavemysputumexaminedtodetermineifIhaveTB.

    Explainhowsputumexamisdoneandwhereitcanbedone.Outcome:IamconfidentthatIcangetacorrectdiagnosisattheDOTScenter.

    ReferclienttoDOTScenterforsputumexam.Outcome:IamgoingtotheDOTScenterforproperdiagnosis.

    SeekEarlyCare

  • Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations.

    ChoosingtoseekTBcarefromDOTSfacility

    Greetpatientwarmly.Praisepatientfortakingtheinitiativetoseekcounseling.Ensurethatprivacywillberespected.Outcome:IamwelcomeattheDOTSfacility.Iknowthatmyprivacywillbeprotected.

    AskaboutwhatclienthaslearnedaboutTBandwherehe/shegotinitialcounseling.Outcome:IcanbeopenwiththehealthproviderattheDOTScenteraboutmysymptoms.

    GiveclientaccurateandpersonalizedinformationonTBandhowitcanbecured.Outcome:TheDOTScenterisgivingmegoodTBinformation.

    HelpclientremoveanyremainingdoubtsaboutsputumexaminationtodiagnoseTB.Outcome:IwillhavemysputumexaminedtodetermineifIhaveTB.

    Explainhowsputumexamisdone.Outcome:Iamconfidentthatbygivingsputumsamples,theDOTScenterwillgivemeanaccuratediagnosis.

    Remindclientaboutneedforadditionalsputumsamples.Outcome:IamgoingbacktotheDOTScentertogiveadditionalsputumsamples.

    Goto

    DOTSFacility

  • Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations.

    Complyingwithdiagnosticprocedures

    Praisepatientfortakingcareofhis/herhealthandundergoingdiagnosis.Outcome:Thehealthproviderismypartnerinensuringgoodhealth.

    Askaboutclientsconcernsabouttheproperdiagnosticprocedureandaddressanydoubts.Outcome:IcanbeopenwiththehealthproviderattheDOTScenteraboutmysymptoms.

    Tellclientthereasonwhythereisneedtosubmitthreesputumsamples.Outcome:IunderstandwhyIneedtosubmitthreesputumsamples.

    Helpclientremoveanyremainingdoubtsabouttheneedforthreesputumsamples.Outcome:Iwillsubmitthreesputumsamplesasrequired.

    Explainhowsputumexamisdone.Explainhowtopreventotherfamilymembersfromgettinginfected,incaseofpositiveresults.Outcome:IknowwhattodosoIwillnotinfectmembersofmyfamily.

    Remindclientaboutscheduleofsputumsamplesandwhenresultscanbeobtained.Outcome:IamgoingbacktotheDOTScentertogettheresults.

    Complete

    Diagnosis

  • Explainhowmanytabletsneedtobetakenandwhenandtheneedforatreatmentpartner.Outcome:Iwilltakemymedicinesreligiouslywiththehelpofmytreatmentpartner.

    Scheduleandreferclientonfollowupsputumexams.Outcome:IwanttoknowthatIamgettingcured.Iamgoingbackforthefollowupsputumexamasscheduled.

    Helpclientunderstandthedangerstohim/herandhis/herfamilyofnotstartingtreatment.Outcome:Iamreadytostarttreatment.Idontwantmyfamilytoalsogetsick.

    Praiseclientfortakingcareofhis/herhealthandcompletingsputumexam.Outcome:Thehealthproviderismypartnerinensuringgoodhealth.

    AskaboutclientsconcernsabouttheDOTStreatmentandaddressanydoubts.Outcome:ThemoreItellmyhealthprovideraboutmyconcerns,theeasierwillbemytreatment.

    Explainpossiblesideeffects.Tellclientaboutwhattodoincasehe/shefeelsanysideeffects.Outcome:IknowwhatIneedtodoincaseofsideeffects.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations.

    Agreeingtoundergotreatment Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    StartTreatm

    ent

  • Committingtocompletetreatment

    Praisepatientforbeingconcernedabouthis/herhealthandreturningtothehealthcenter.Outcome:Thehealthproviderismypartnerinensuringgoodhealth.

    Askifpatienthasbeencomplyingwithtreatmentincludingfollowupsputumexams.Askaboutanysideeffectsandhowthetreatmentpartnerishelpingtheclient.Outcome:ThemoreItellmyhealthprovideraboutmyconcerns,theeasierwillbemytreatment.

    Ifpatientfeelssideeffects,tellpatientaboutwhattodo.Outcome:IwillnotallowthesideeffectsIfeeltopreventmefromcompletingtreatment.

    Helppatientthroughanydiscomfortandsideeffectstheyfeel.Outcome:IwillcontinuetreatmentinspiteofthesideeffectsIfeel.

    Explaintheneedtocompletetreatment,includingallfollowupsputumtests.Outcome:Iwillcontinuetreatmentandwillsubmitmysputumforfollowupexams.

    Scheduleandreferpatientforfollowupsputumexams.Outcome:IwanttoknowthatIamgettingcured.Iamgoingbackforthefollowupsputumexamasscheduled.

    Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations.

    ContinueTreatm

    ent

  • Bringingdefaultersbackintotreatment

    Praisepatientforbeingconcernedabouthis/herhealthandreturningtothehealthcenter.Outcome:Thehealthproviderismypartnerinensuringgoodhealth.

    Askdefaulterswhytreatmentwasstopped.Askaboutanyproblemswiththetreatmentpartner.Askhowlongtreatmentwasfollowedbeforedefault,andaskhowlongtreatmenthasbeenstopped.Outcome:ThemoreItellthehealthprovider,thebetterIcanbehelped.

    Tellpatientaboutthedangerofstoppingtreatment,includingtheriskofdying.Outcome:Idontwantmyhealthtoworsen.Icanstillbecured.NowIwilltaketreatmentseriously.

    Helpdefaulterunderstandthatheorsheneedstorestarttreatmentwithatreatmentpartnertoensurepropertreatment.Outcome:Iresolvetorestarttreatmentandgetcuredwiththehelpofmytreatmentpartner.

    Iftreatmenthasbeenstoppedforlessthan2weeks,explainwhatmedicinestotake.Ifmorethan2weeks,explainneedfornewsputumexam.Outcome:Iknowwhattodotogetcured.

    Scheduleandreferpatientfornewsputumexam.Outcome:Ineedtohaveanewsputumexamsothatthehealthproviderwillknowhowtotreatme.

    Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations.

    ContinueTreatm

    ent

  • SeekingconfirmationascuredTBpatient

    Praisethepatientforcompletingthewholecourseoftreatment.Outcome:Myhealthprovideriswithmeeverystepoftheway.

    Askifthepatienthasanytroublewithhavingthefinalconfirmatoryexam.Outcome:Iwillcontinuetobeopentomyhealthprovider,particularlyatthislaststageoftreatment.

    Tellthepatientoftheneedtohavethefinalsputumexam,toensurethathe/sheisfullycured.Outcome:Thelastexamisneeded,soIwillbecertainofcure.

    Helpreinforcetheimprovedhealthseekingbehaviorsofthepatient.Outcome:Withthehelpofthehealthprovider,Icantakebettercareofmyhealth.

    Explaintopatientwhythereisaneedforthelastsputumexam.Outcome:Iknowwhythereisaneedtohavethelastsputumexam.

    Scheduleandreferpatientforthelastsputumexamaftertreatment.Outcome:IwilltakethelastsputumexamsoIwillknowforcertainthatIamcured.

    Counselingsteps

    GreetandPraiseGreetclientwithrespectandfriendlinesstomakehim/herfeelwelcomeandopenabouthis/herfeelings.Praiseclienttoreinforcehis/herpositivebehaviors.

    AskandListenAskappropriatenonjudgmentalquestionstogetreasonsforclientsvisit,andhis/herfeelings,concernsandfears.Listentowhathe/shesaysandhowhe/shesaysit,showinginterestandunderstanding.

    TellandEncourageTellaccurateandpersonalizedinformationaboutTBandDOTS,toaddressbarriersthatpreventstheclientfromundergoingdiagnosisandtreatment.Encourageopenness.

    HelpandResolveHelpclientdecideonDOTSdiagnosisandtreatment,addressingpositiveandnegativeconcerns.Resolveanyremainingconcerns.Addresspossiblebarrierstotreatment.

    ExplainandShowClearlyexplainTBDOTSdiagnosisandtreatment.Showanddemonstratewhatneedstobedoneduringtreatment.

    Return/ReferandRemindEncourageTBclienttoreturnforanytreatmentproblemsandfollowup.ReferTBclienttoappropriatefacilitiesforspecialsituations. Com

    pleteTreatm

    ent


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