4.1. Guiding principles for health education and counselling

With regard to the rights of patients outlined in the declaration of the rights of people affected by TB (9), the following are particularly pertinent as the guiding principles for patient education and counselling:

  • the right to be treated with respect and dignity;
  • the right to information;
  • the right to confidentiality.

People have a right to complete and correct information related to TB and the suggested treatment’s risks and benefits explained in simple language that patients can easily understand. If possible, written information should also be shared. The goal of counselling is to make sure that people have understood the information and to answer any questions they might have. The health-care provider should also correct any commonly held misconceptions or myths about TB.

A person’s independence and right to choose should be respected. The health-care providers should respect the patient’s choices and beliefs and not make decisions for the patient. All efforts should be made to involve the patient in making a treatment plan. WHO clearly states that every person affected by TB has the right to liberty and security of person and that involuntary detention, hospitalization or isolation of a person with TB is a deprivation of liberty and violation of the security of the person (9). WHO also narrowly defines the circumstances in which this right can be overridden but makes clear that this must be for the shortest duration possible and in accordance with strict guidelines.

Section 2 on the people-centred approach described how people suffering from TB might face stigma, prejudice or discrimination from the community as well as from health-care providers. All efforts should be made to protect people from discrimination and to engage them in the most inclusive way. They should be treated with respect and dignity no matter what their age, gender, financial status, social situation, religion, sexuality or any other factors. In order to reduce stigma and discrimination, patients should be reminded that TB is not the result of any wrong behaviour and that most people completely recover after completing treatment.

People suffering from TB should have personal privacy and confidentiality. It is important that they are seen in a private space for health counselling. They should be assured that information about their care is confidential and that it will not be shared with another person without the patient’s permission. Other family members should be invited to join the discussion only after receiving permission from the patient.

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