Women and children experience almost 45% of the tuberculosis cases in India, but they are the least likely to receive comprehensive treatment that can cure the disease. In partnership with India’s Ministry of Health, ECHO India, an independent nonprofit trust established in 2008 in partnership with Project ECHO, intends to change that and create equitable care for all.
Dr. Mahesh Gorla, an assistant professor of pediatrics and a pediatric tuberculosis expert with ECHO India, shares why advancing gender equity is embedded in ECHO’s work.
“The most vulnerable are the women and children because they don’t have financial freedom to pay for health care, or because they need a husband’s permission to seek medical help,” Dr. Gorla explains. “They will often not receive health care until things are out of hand. And even if a sick woman or child reaches a nearby health care facility, there is typically not an expert in treating tuberculosis.”
At left, Dr. Anuradha Rai, a leader in gender equity in education for ECHO India, speaks with fellow members of the Gender Equity panel at the 2023 MetaECHO conference.
Tuberculosis, left untreated, has a 50% mortality rate. India accounts for about 25% of the tuberculosis cases globally. The ECHO Model is what makes a difference for these women and children.
“Now, at these health care facilities all over the country, there is an expert, and there is also outreach to the community for contact tracing, even for people who might not come in for care,” notes Dr. Gorla.
In just three years, ECHO India has trained more than 29,000 providers on best practices in tuberculosis treatment — about 60% of the total workforce needed to eliminate tuberculosis, according to India’s Ministry of Health. ECHO India is training doctors as well as lab supervisors, field leaders, patient counselors and community health workers.
“You can see how we have to take every case seriously for men, girls [and] women. Each case is so important,” says Dr. Gorla.
Through ECHO sessions, providers and experts pool their knowledge on unique cases, best-practice treatments and cultural considerations in patient care. When Dr. Sumalata Chittiboyina, a tuberculosis epidemiologist with more than 20 years of experience, considered treatment for an 18-month-old boy, she worked closely with an ECHO colleague to decide on a treatment plan and follow-up.
“It is very rare to detect a case in someone that young. And the correct treatment for a pediatric patient is much more specific [in dosing and frequency] than adults,” Dr. Chittiboyina says. Today, the patient is a happy and healthy three-and-a-half-year-old thanks to early detection and comprehensive treatment.
By increasing the number of trained providers, Project ECHO is building pathways so that women and children have a chance to receive the highest quality treatment for tuberculosis, and to thrive.