Betiglu Legesse is always trying to ensure that the patients he cares for stay on their tuberculosis (TB) treatment from beginning to end. It’s a challenge: In 2020 alone, more than 60 of his patients stopped their treatments, often due to many interplaying factors, such as forgetfulness, length of the treatment itself, fear of side effects, and a long distance to the health facility.

Betiglu works as a TB focal person at the about 50 kilometers east of Ethiopia’s capital city, Addis Ababa. Trained by the USAID Eliminate TB Project, led by Management Sciences for Health, Betiglu knows that addressing treatment adherence is critical, since early termination of TB treatment can leave patients infectious and symptomatic and can lead to greater challenges, such as drug-resistant TB. As part of their work building the capacity of TB health providers in the Oromia region, the project’s regional supervisors provide quarterly supervision to Betiglu and other health providers like him to deliver quality, sustainable TB services, including preventing multidrug-resistant TB.

Armed with this knowledge, Betiglu pioneered an idea that would encourage his patients to come to the health facility regularly to take their pills. On a patient’s first day of treatment, they received a pot and a seedling. Whenever a patient came to the facility to care for their plant, they also received their TB drug regimen. Betiglu found his method to be effective and wants to expand it beyond his current 50 patients who come in regularly for treatment. He says, “The greenery works by showing a bright future for TB patients.”

One of his TB patients, Temesgen Zewdu, began his treatment in 2020 but stopped. After repeated adherence counseling, he agreed to resume treatment and was given a plant to care for. His most recent sputum test, after five months on treatment, showed a negative TB result. He now encourages other TB patients to regularly visit Betiglu, saying, “Planting is really interesting, it brings hope and prolongs life. Before I only thought of plants giving us firewood, but now I see how plants give us life.”