How mobile clinics are helping to end TB

Mobile clinics can bring health services as close as possible to people.

They are staffed by skilled health professionals and are supported by an incredible network of community health workers, making sure that communities know what services they can access, free of charge.

In many Amref programmes across communities in Africa, mobile clinics are a lifeline for people in need of healthcare but who live many hours’ travel from their nearest health centre.

In late 2023, a pilot programme brought a specialist tuberculosis (TB) mobile clinic to Zanzibar. Over the course of a week, it screened—a total of 1,400 people, reaching an average of 200 people a day.

Here, Dr Rahma Omar, Regional TB Coordinator in Zanzibar, discusses why mobile clinics are a critical tool in eradicating TB.

Why do we need mobile clinics?

Even when we reach a community with health education and normal screening outreaches, we know that there are still some people who will not be able to get properly diagnosed.

This is because a sputum sample is needed for diagnosis. On the screening outreach, some people will manage to produce a sputum sample and others will not. The ones who cannot need to then take time out of work and their normal routines to get to a facility to get tested.

Most of the community members that we reach are low income. If you ask them to move from there to the facility, it takes a lot of time and costs them transport fare. Even if they tell you that they will go, most of them never do.

How many people, on average, do go for testing?

I’ll tell you what that looks like in numbers. From January to March 2023, we identified 900 people with presumed TB symptoms. Of them, we only managed to test 500. That left 400 people who have not been tested. Those people, unless they are diagnosed and start treatment, could be transmitting TB to others in the community.

How does the mobile clinic solve that issue?

A mobile clinic is a TB one-stop-shop. It’s fully mobile, so we can drive it to a marketplace, school, or any other place where a community gathers.

With the mobile clinic, we can screen community members, and we can investigate those cases of people who are identified to have symptoms straight away.

We test those cases, and if we get a positive diagnosis for TB, we can initiate the treatment right there.

Before, a person would have to spend hours to get an x-ray at a facility. The mobile clinic allows us to identify, investigate, test, diagnose and start treatment for people in about 30 minutes.

What happens after the mobile clinic leaves? What does a patient do?

Every person who is diagnosed with TB and starts treatment with the mobile clinic team is linked to their own community health worker.

The community health worker will support them through treatment. Read more about the essential work CHWs do to end TB in their communities.

There was a pilot mobile clinic project in Zanzibar last year. Is there a plan to have a permanent mobile clinic in Zanzibar?

Yes—malaria in Zanzibar is very nearly controlled. I believe having a mobile clinic here in Zanzibar will help us to eradicate TB.

The government is providing the budget to procure the mobile clinic for Zanzibar, but operational costs are quite high. We need fuel to drive the clinic, to power the generators that allow the diagnostic laboratory equipment and the x-ray to run.

We need to find the budget to operate this, because it is a basic need. It will help us to reach remote communities, and to reach more people.