During the unprecedented COVID-19 pandemic, movement restrictions related to physical distancing, quarantine and lockdowns help reduce disease transmission, but may have impacts on other health services and activities. This in turn affects patients who need continuous care and support.
One of our Sub-recipients, the International Union Against Tuberculosis and Lung Disease (The Union), has initiated an innovative approach to continue providing support to MDR-TB patients. With financial support from the Global Fund, The Union is implementing its Community Based MDR-TB Care project in 27 townships in Mandalay, Sagaing and Magway regions and Shan State.
Innovative cash support to MDR-TB patients
Daw Kyin Ngeik Nyaung is from Khampat town, which is near the border with India, in Tamu Township of Sagaing Region. She is an MDR-TB patient and has been receiving XDR-TB treatment for 13 months through The Union’s Community Based MDR-TB Care project, supported by the Global Fund. She has been receiving directly observed treatment (DOT) in the evenings, and monetary support amounting to 58,000 Myanmar kyat monthly for transportation costs and nutrition supplementation.
Usually, cash support is transferred through an automated teller machine (ATM) in the middle of every month. For patients who are not able to use the ATM service (for example, if the patient does not have a National Registration Card needed for the service, or lives in a village or hard-to-reach area where there is no ATM), The Union staff provide cash in person during home visits.
Normally, Daw Kyin Ngeik Nyaung receives the cash support from her health provider during home visits. However, the movement restrictions and physical distancing applied during the COVID-19 pandemic mean that the health provider can only visit her once every two months.
“There is no ATM in our town, so my daughter has to go to Tamu to withdraw the cash, which takes one-and-a-half hours by motorbike. It is very challenging for us,” she said.
To overcome these challenges and maintain patient support while respecting the need for physical distancing, The Union has started using an innovative way to transfer cash support through Wave Money, which allows instant money transfer by mobile phone or through local Wave Shop agents. This innovative technology allows cash transfers to patients while reducing the need for visits and contact.
“Now I can easily access the Wave agents in Khampat and receive the cash in hand in the second week of the month,” Daw Kyin Ngeik Nyaung explained.
The Union has started using the Wave Money platform in five townships, transferring cash to 17 patients in July 2020.
U Than Soe’s son from Zee-phyu-pin village of Naung-Cho, Shan State, is one of the patients who is receiving support through Wave Money. “My son was diagnosed with MDR-TB on 30 April 2020. He has been admitted to the TB hospital in Patheingyi Township, Mandalay, because of his serious illness. We have been here with him for three months but we cannot apply for an ATM card as we do not have the necessary supporting documents with us here,” U Than Soe said.
“Starting from July, The Union is transferring cash support through Wave Money and we receive the cash in the second week of the month. I am used to Wave Money as I have been using it for business in my village. It is very convenient for me and it is easy to withdraw the cash,” he said with a smile.
Making disbursements faster and more efficient
Ma Wai Mar Aung, MDR-TB nurse from The Union’s Community Based MDR-TB Care project, welcomes this approach. For those who cannot access the ATM service, she has had to provide cash directly to the patients during the home visits.
“It was challenging and risky for me when I had to travel to far villages with cash. Now, with this platform, patients can easily withdraw the cash from local agents. This platform saves time and reduces the need for frequent visits and appointments with patients during the COVID-19 pandemic. It’s very effective,” she said.
The Community Based MDR-TB Care project partners with healthcare workers, nurses and community volunteers to establish an extensive network of people equipped to provide MDR-TB care and support services. Support to MDR-TB patients includes financial and nutritional support, community mobilization through specially trained volunteers, evening DOT, systematic household contact screening and adherence assistance, psychosocial and nutrition advice support for patients, ensuring infection control practice and timely referral for clinical management of any treatment side effects. To date, 3,672 MDR-TB patients have received monetary support through the project.
