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• Influence those receiving treatment to complete the regime.
• Influence those successfully treated to become advocates.

Midstream efforts that focused on families, co-workers, neighbors, friends,
and healthcare workers were also specific in desired behavior outcomes:

• Encourage friends and family members with symptoms to get diagnosed
and accept treatment, and support them in completing treatment.
• Participate, when needed, in the DOTS program by observing the patient
take the medication.
• Additionally, for healthcare workers:
• Integrate TB services into the primary healthcare system.
• Upgrade provincial hospitals, district-level hospitals, and primary
healthcare clinics.
• Provide more effective diagnostic services, counseling, and treatment.
• Strengthen human resource capacity by training staff at all levels in
clinical, laboratory, and counseling skills, helping to overcome biases.
• Conduct DOTS.
Upstream efforts were intended to persuade:

• Policy makers to:
• Provide support for expanded and improved clinical services.
• Help ensure availability of drugs and laboratory supplies.
• Work to develop partnerships and contributions from international and
local authorities, community-based organizations, and the private sector.
• Media to attend and cover special events, as well as report on key
TB-related facts and program activities.

Knowledge objectives were educational in nature, recognizing that behavior
change would depend on target audiences knowing what symptoms to watch
for, how the disease is spread (and not), the effectiveness of treatment, that
treatment is free, and that fully completing treatment was necessary in order to
be cured. Belief objectives took on reducing stigma and correcting misconcep-
tions among all target audiences, as well as the general public.

B A R R IER S

Formative research was conducted by the NTCP to assess the public’s, as well as
healthcare workers’ current knowledge and attitudes regarding TB. Findings
confirmed suspicions of widespread stigma, misconceptions, and lack of the