Tuberculosis Education in Mumbai, India

Nowadays, there are many established organizations that hold the promotion of healthy living as their main goal. Each country tries to investigate different aspects of human life and understand what improvements can be offered at a given moment. The United Nations Association of Greater Philadelphia (n.d.) aims to advance the interests of Americans in the global arena and is looking to introduce multiple sustainable development goals to end poverty and hunger, reduce inequality, and ensure widespread access to reliable sources. The scope of work defined by this organization is impressive, indeed. Not many people are ready to spend their resources and set out to accomplish such large ambitions. Amongst such a wide range, it is possible to try and focus on one of these goals, as an example.

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In this paper, the promotion of healthy living through the reduction of epidemic cases of tuberculosis (TB) will be discussed with specific regard to the current achievements and challenges observed in a specific part of India, its west coast, Mumbai. Mumbai is one of the most populous cities in the country with a population of about 12,4 million people who are in panic of being faced with a new bacteria that can spread fast (Narayan, 2015).

The prevention of epidemics is a step to be taken in such regions as Mumbai, India, in the shortest possible period of time. With frequent, and increasing migration and globalization, the results achieved by one country or even by one region may greatly influence the health conditions of other countries. A program with clear objectives to support Mumbai people in their intentions to reduce the incidence of epidemic TB diseases will be developed, considering such issues as target population needs and possibilities, timeline, costs, and expected outcomes.


Despite the fact that India is a middle-income country, it is the second most populated country in the world, with a population of around 1.3 billion, and has the third-largest recorded epidemics (Vasanthakumari, Vijayalakshmi, & Patlia, 2015). In the whole country, death rates caused by TB are about 27% of all global deaths in 2013 (Murray et al., 2014). Millions of children are living with TB, among other serious infections, with many of them already have lost their parents or caregivers due to this disease. Particularly in Mumbai, the annual rate of deaths because of TB is 213, with about 30,000 new cases registered annually (Narayan, 2015). The quality of life in Mumbai is not high, and people have to use all available resources to try and achieve improvements on their own.

Many countries are focused on reducing mortality rates from TB. India, in its turn, has already had notable success in battling HIV/AIDS (the number of cases has been reduced by 39%) but has so far failed to achieve similar results with TB (Prasad, 2014). These results prove that India has serious potential in the fight against such diseases that are responsible for the death of millions annually. However, the existing challenges for the citizens of Mumbai, such as a profound nursing shortage, uncontrolled sexual contacts, the absence of health education, and the prevalence of addiction, affect health care and determine the quality of life (Garner, Raj, Prater, & Putturaj, 2014).

The studies developed by Vasanthakumari et al. (2015), Abhilash (2015), Garner et al. (2014), and Lundberg, Doan, Dinh, Oach, and Le (2016) not only prove the urgency of the health issue chosen for analysis but also demonstrate various ways and methods that can be used to support Mumbai people and provide them with informative guides on how to ensure healthy living.

The campaign to eradicate such epidemic as TB in Mumbai has the potential to touch and improve thousands of lives through detecting and reporting TB cases and providing access to effective TB services (“TB in India,” 2017). One of the initial steps that can be offered to the population is the promotion of a program that is called “Education through Cooperation.” Mumbai people are ready for communication and cooperation to protect themselves against TB.

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“Education through Cooperation” is a new program that can be undertaken by the citizens of Southern India to ensure good, or at least better, health. However, it is necessary to acknowledge that an idea to ensure health for people of all ages is a very general topic, and it is better to narrow it down so that clearer steps and objectives can be explained. The United Nations Association of Greater Philadelphia (n.d.) proposes several supplementary targets to guide people in their intentions to practice healthy living.

As such, the eradication of TB is one of the targeted aspects. The overarching goal of the offered program is to reduce the number of TB deaths among the Mumbai population by 15% within the next two years by ensuring good health activities and education for people of all ages through investigating available sources, promoting cooperation, and discussing basic guidelines. To achieve this aim, it is possible to take the following SMART steps:

  1. Communicate with 200 citizens of Mumbai about epidemic diseases and ask questions to understand what they know and what they have to know (specific);
  2. Investigate the current cases of TB and the number of people with TB in two years (measurable);
  3. Discuss the ways to exchange knowledge via social media and face-to-face meetings (achievable);
  4. Examine the possibility to cooperate with medical employees and educate Mumbai people to promote hygiene, safe contacts, and care (relevant);
  5. Decrease the number of deaths caused by TB among the Mumbai population by 15% in two years (time-oriented).

Health communication is an integral part of the prevention of epidemic diseases. Mumbai is the region where the availability of medication and high-quality healthcare services is higher than in other Indian parts. TB is an infection that anyone can take, and people with low income are under a more serious threat than other citizens (Jacobsen, 2014). Instead of thinking about how to find new sources or fund innovations, it is better to use what is already available to hospitals, medical workers, and nurses to support the Indian people in Mumbai.

Description of the Program and Its Innovativeness

The “Education through Cooperation” program is a comprehensive set of steps and guidelines that can be offered to Mumbai citizens in their local hospitals and medical facilities by nurses or other healthcare workers. It includes intervention measures and several pre- and post-intervention investigations that aim at promoting awareness about TB. In this program, several explanations and definitions are given to identify the basic TB concepts, as well as the policies behind the scheme, to help people understand the program. This knowledge manages participants’ expectations and illuminates the benefits/threats of new steps.

In Mumbai, much attention is paid to the causes that make the population vulnerable. As a rule, people of all ages are challenged by the inability to fulfill their basic needs and deal with such problems as poverty, infections, inappropriate nutrition, homelessness, and limited access to medications on a daily basis (Vasanthakumari et al., 2015). It is impractical to believe that the solution to all these issues, for all citizens of Mumbai, is possible through just one program.

However, it is reasonable to hope that at least several steps can be taken to achieve certain specific goals. The example of Vietnamese healthcare workers can be used to understand how a lack of education about the basics of diseases is one of the main problems in society (Lundberg et al., 2016). Babu, Madan, Veluswamy, Mehra, and Maiya (2014) underline the necessity of skill-oriented knowledge and motivational messages to deal with risk factors and threats.

Finally, Garner et al. (2014) help to demonstrate how community education is one of the best strategies in terms of ensuring the improvement of social perceptions of health care, nursing, and the possibility of prevention. Taking into account all these studies and experiences, “Education through Communication” consists of the following parts:

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  1. Attention to the level of knowledge of Indians who live in Mumbai about TB is needed. This program should have a starting point, and it is the recognition of what people know and may want to know that will help ensure healthy living. Simple questions to the population such as, “Do you know what TB is?” or “Do you know if some of your relatives have tuberculosis?” can be sent via e-mail or asked personally.
  2. Visits to local schools and hospitals are required. They can help gather information about how Mumbai people learn from new material and improve their knowledge about health and TB need to be conducted. This should be done in cooperation with hospital leaders, nurses, and educators who can explain the goals of the program and the expected outcomes.
  3. Means of communication have to be identified. This step helps to clarify what the most convenient way is to share information about TB. It is expected that people would support the idea of face-to-face communication and would be keen to visit free meetings.
  4. There is a hope to invite several experts from other countries. They can share their knowledge and experience with local medical workers and nurses. International practice and cooperation with ordinary people introduce another element of innovation to the program.
  5. The above-mentioned interventions would ideally last two years. This approach can enable proper evaluation of its benefits, as well as the challenges faced. As soon as people get access to health education and international communication, the possibility to take the first step and end epidemics in India can be realized.

The main policies that have to be taken into consideration in this program are:

  1. Health communication offers new opportunities to Indians in their intentions to ensure healthy living.
  2. Training, education, and communication help to identify their knowledge gaps and correct mistakes.
  3. It is never too late to study. Therefore, people aged between 18 and 25 or 55 and 70 are invited to participate in the program.

This program can be made available to all Indian people who understand the necessity to fight against epidemic disease and prevent their development. TB cases may have different outcomes. The essence of this program is to support people and prove their readiness to end epidemics relying on their knowledge and experience exchange.

Target Population

One of the significant steps of the development of this program is the identification of its target population. In addition to the fact that all participants will be citizens of Mumbai, it is also necessary to clarify such characteristics as age, gender, social status, language, and education degree (if any). It has been decided to work with two groups: the first group includes people of both genders, aged between 18 and 25; the second group consists of males and females aged between 55 and 70. The distinguishing feature of these groupings is the level of knowledge and personal experience of the participants. Younger participants may rely on fresh approaches and modern education, while older participants can use their past experience, knowledge, and family history.

Another important aspect is the identification of social status and level of education. It is hard to invite people with the same indicators. Therefore, these two factors have to be optional. Still, it is expected that people from different social classes will participate, learn something new, and share their knowledge with other representatives of their social groups. Finally, the participants of the program have to speak and understand English. There are many official languages in India, but English is the most frequently used foreign language. Therefore, to avoid translation complications and misunderstandings, it is better to work with Indians who know English well.


The “Education through Cooperation” program has been created as a long-term project in Southern India. A two-year period has been determined for implementation and evaluation of the outcomes of the policies and interventions. Education cannot be promoted in a short period of time; similarly, no guarantees can be given to prove that knowledge and information have been “absorbed” at the necessary levels. Taking on board these concerns, two years, therefore, is the initial time given to implement the program and observe its first results. It is expected to observe changes and reduce the number of TB deaths. The following timeline will be used:


This timeline is not final and can be modified over time, as soon as one stage is over, or when new details or requirements are established. It is possible to extend the final deadline for the program implementation. However, it is not recommended to shorten the deadline of two years because this is the minimum time required to complete the task and meet the goals set.

Approximate Cost

It is a difficult task to predict the approximate cost of the program because much depends on the participants and their intentions to cooperate. At this moment, it is possible to identify several aspects and their approximate price:

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  • Flight from the United States to Mumbai – approx. $500-700
  • Living costs in Mumbai for one month – approx. $1500-2000
  • Brochures – approx. $150-200
  • Services of 1-2 educators in the country for one month – $5000-10000
  • Blood tests for TB – $3-5 per test (expected to test at least 100 people of different ages) = $300-500
  • Additional costs (to cover unpredictable losses or new meetings) – $500
  • The total cost for this program to be developed by an American researcher in India is about $12000.


If the goals of the program are met and the plan of intervention is followed, several short-term and long-term outcomes may be expected. One of the main benefits is the recognition of current health problems in Mumbai. Research of recent TB epidemics, social concerns, and global problems promotes the creation of a general picture of the quality of human life in Mumbai. Another short-term goal is the recognition of the number of people who want to improve their lives and the possibility to increase this number by up to 30%. It is also possible to increase international donations for the improvement of Mumbai lives by up to 10%; when people become more aware of recent health problems, some may be ready to help and involve new participants.

In addition to a number of short-term outcomes, there are several important long-term outcomes that have to be mentioned. First, changes in mortality rates from TB are expected (increase up to 15%). Second, the quality of life in Mumbai can be improved. Finally, Indian experiences in battling epidemics can help other countries to achieve similar results.


In general, the evaluation of the studies and the analysis of statistics show that India is a country with a population challenged by frequent cases of TB. Despite numerous attempts to find a solution and decrease the number of deaths caused by TB, Indians are still in need of additional resources, medication, and support that can be offered at the international level. The program “Education through Cooperation” is a chance for Indian people to access international knowledge and experience, and apply this to local practices and everyday life activities to achieve one mutual goal.

The exchange of knowledge and precautionary methods are potential affordable approaches that can be offered to India. It is a middle-income country, and it is wrong to believe that extensive financial support can be achieved. Therefore, it is better to rely on the steps that can be taken by ordinary people who are ready to work and share their knowledge with each other. Education through cooperation at the international level is an innovative idea for Southern India, where not everyone is able to communicate with foreigners and have the opportunity to learn something new about health. Health communication and education cannot be ignored, and Indians have to take as much as possible from this program.


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Babu, A.S., Madan, K., Veluswamy, S.K., Mehra, R., & Maiya, A.G. (2014). Worksite health and wellness programs in India. Progress in Cardiovascular Diseases, 56(2014), 501–507. Web.

Garner, S. L., Raj, L., Prater, L. S., & Putturaj, M. (2014). Student nurses’ perceived challenges of nursing in India. International Nursing Review, 61(3), 389-397.

Jacobsen, K.H. (2014). Introduction to global health (2nd ed.). Burlington, MA: Jones & Bartlett Publishers.

Lundberg, P.C., Doan, T.T.K., Dinh, T.T.X., Oach, N.K., & Le, P.H. (2016). Caregiving to persons living with HIV/AIDS: Experiences of Vietnamese family members. Journal of Clinical Nursing, 25(5-6), 788-798.

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