Mercy Corps Pakistan is conducting a cost-effective analysis of different active TB case-finding models, including the latest technology, for optimizing resource allocation in countries burdened by high TB prevalence like Pakistan. This study will evaluate the cost-effectiveness of diverse implementing strategies for screening, sample collection, and diagnostic tools to identify TB patients during Active Case Finding (ACF). A cluster randomized cross-over trial (CRXO) will be employed with three arms comparing novel ACF strategies using varying screening tools and targeting high-risk communities, household, and neighborhood contacts using mobile screening units.

CGPH will take the lead on scientific aspects, applying program science approach to the study, conducting evaluations at baseline, midline, and end line, monitoring interventions, and performing research studies, including qualitative assessments to gauge the feasibility of new methods.

CGPH will also assist in executing the dissemination plan, which includes organizing seminars, advocacy efforts, and publishing manuscripts and abstracts. An extensive report or white paper will be created to inform all relevant stakeholders about the new tools being tested and the pragmatic trial. This report will be supported by original research and publications.

Partner: Mercy Corps Pakistan

CGPH-Pakistan is leading the analysis of intervention outcome of Active Case Finding (ACF) Screening Program for targeting strategies. It is a pragmatic stepped wedge cluster randomized trial that will evaluate whether a targeted approach towards ACF, supported by artificial-intelligence software (MATCH-AI), can increase yields of TB cases detected. The study is being conducted on a national scale in Pakistan and is embedded within the routine operations of the implementing partners of the National TB Program. The study will provide empirical evidence for the potential benefit of targeting of ACF interventions in a real-world setting, within a high-burden TB country.

Partner: Mercy Corps Pakistan

The initiative was taken to build the capacity and to introduce the concept of program science to the program staff (PR and SRs of March Corps) from TB background. It aims to optimize population-level outcomes and the usage of routine program data to identify areas for research and improvement and set goals accordingly. Selected PR and SR staff were introduced to a training program to ensure that research and science are embedded within their regular programs , which will help develop research and analytical skills among program personnel for regular analysis of program data and its use for program improvement

Partner: Mercy Corps Pakistan & SR's

This completed study explored the barriers and enablers in planning Active Case Finding (ACF) camps in Pakistan, with a particular focus on site selection using the MATCH AI technique. It examined the perspectives and experiences of healthcare workers in applying MATCH AI for camp location identification and compared this approach with the conventional method of site selection, which relies on routine TB notification data and local knowledge. The study further assessed how the revised approach influenced staff efficiency in planning, workloads, processes, and data management. Findings provided valuable insights into the strengths and limitations of both methods and offered practical recommendations for optimizing ACF camp planning through technology-enabled decision-making

Partner: Mercy Corps Pakistan

This project successfully developed strategies to engage retail pharmacies in notifying unreported TB cases. A detailed assessment of the existing intervention modality was conducted to identify gaps and areas for improvement. Consultative meetings were held with key stakeholders, including the National and Provincial TB Control Programs, to align efforts and establish guidelines and SOPs. An effective notification and registration mechanism were designed to integrate pharmacy-identified patients into the national surveillance system in line with NTP standards and ethical considerations. The mobile application used for the intervention was reviewed, and modifications were proposed to improve its functionality and user experience. Additionally, specific key performance indicators (KPIs) were defined to evaluate the effectiveness of the intervention. Overall, the project strengthened pharmacy engagement in TB case notification and provided a structured framework for improved surveillance and reporting.

Partner: Mercy Corps Pakistan