Paper Title
Implementation Science Research in Paradigm Shift of Tuberculosis Control Programmeby using Mobile Digital Cxr and Genexpert in Hard to Reach High Risk Population in Sabah, Malaysia:a Concept Paper

One of the SDG targets for 2030 is to end the global TB (Tuberculosis) epidemic. 29% of all cases in 2012 were in South-East Asia by WHO Global Tuberculosis Report 2013.TB mortality rate increases from 4.5 to 5.3 in 2012 to 2013 in Malaysia. A community based cross sectional quantitative study was conducted from June 2017 to June 2018 in high risk TB Hot spots areas in KK, Sabah by collaborative research with UMS researchers and Sabah State health Department during annual TB screening and case detection by using mobile CXR and GeneXpert with sample size of 900 people in high risk population in Sabah. There is know-do gap existed not only in organizational level with Quality gaps in health care settings due to capacity , funding, skilled manpower and limited geneXpert usage but also in population level with inaccessible to diagnostic facilities to get treatment in time. This paper is a concept to apply the implementation science particularly for system readiness, stakeholder analysis and engagement in this paradigm shift of TB control programme.Our objectives are to determine the effectiveness and usage of new intervention mobile CXR and GeneXpert in hard to reach population and to know whether the implementation method is effective in diagnosis of Tuberculosis in hard to reach high risk population. Active implementation framework, Diffusion of innovation, REAIM framework, System readiness-Competency, organizational, leadership drivers, Stakeholder engagement and analysis and Effectiveness implementation Hybrid -3 Design will be used for implementation Science research. Keywords - Implementation Science Research, Stake Holder Analysis And Engagement, System Readiness, REAIM Evaluation Plan, Paradigm Shift Tuberculosis Control Programme, Sabah, Malaysia