Annual Report: TB CARE I - Namibia Year 2 (October 1, 2011 – September 30, 2012)

The program is funded by USAID with a total allocation of USD2.1 million for the second term of the Annual Plan of Activities (APA2). The program's main goal is to improve TB control in Namibia through six technical areas: Universal access, TB/HIV, Programmatic Management of Drug Resistant TB (PMDT), Infection Control, Health Systems Strengthening (HSS), and Monitoring and Evaluation (M&E)/Operational Research (OR). The program achieved significant results in the second year of APA2, including an 85% treatment success rate for new smear-positive TB cases, 90% of TB patients knowing their HIV status, and 31 out of 34 districts having community-based TB care organizations supporting the Ministry of Health and Social Services (MoHSS) in community-based TB care services. TB CARE I continued to provide technical support to the NTLP throughout the year, with over 90% of planned activities implemented by the end of September 2012. One of the major highlights of APA2 was the improvement of universal access to TB services, including the commemoration of World TB Day and TB weeks in Windhoek, the inauguration of an 80-bed TB ward in Rundu hospital, and the provision of community-based DOTS supportive supervision to Erongo and Karas regions. The program also strengthened TB infection control measures, including the installation of Ultraviolet Germicidal Irradiation (UVGIs) in Oshakati and Rundu, and the assessment of TB infection control in all 34 district hospitals. TB CARE I also strengthened programmatic management of drug-resistant TB (PMDT), including the successful conduct of the DR TB international training in June 2012, the receipt of two technical assistance (TA) on PMDT, and regular Central Clinical Review Council (CCRC) meetings on second-line medicines regimens for DR TB patients. The program also strengthened health systems through the revision and launch of the National Guidelines for the Management of Tuberculosis and Leprosy, supporting several trainings for healthcare workers, and hosting several TA's from KNCV TB Foundation on HSS, HRH, PMDT, and general programmatic issues. In addition, TB CARE I strengthened operations research capacity and improved the capacity to analyze data, including supporting the NTLP's participation in the UNION conference in Lille, where Namibia presented 7 abstracts for display and presentation, and the successful conduct of OR training for regional TB managers and national-level staff. The program also developed Standard Operating Procedures (SOPs) for the conduct of zonal review meetings and supported the conduct of quarterly data review meetings throughout the country. TB CARE I operates in all 13 regions of Namibia through technical assistance provided to the NTLP and provides direct support to two regions of Erongo and Karas in the area of community-based TB care services. The program is led by a team of committed public health specialists, support finance, and support staff in the country office.