Challenge TB - Namibia Year 2 Annual Report

The project is funded by President's Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID) and aims to improve access to quality-assured patient-centered care for TB, TB/HIV, and MDR-TB services. The project's main objectives include Tuberculosis and HIV (TB/HIV); Early Access; Programmatic Management of Drug-resistant TB (PMDT); Tuberculosis Infection Control (TB-IC); Health System's Strengthening (HSS); Operational Research (OR); and Surveillance and Monitoring & Evaluation. The expected achievements over the life of the project include increasing the proportion of health facilities/DOT service points with integrated or collaborative TB and HIV services from 8% in 2014 to 80% in 2019, and increasing the proportion of HIV-positive registered TB patients given or continued on anti-retroviral therapy during TB treatment from 85% in 2014 to 100% in 2019. During the period under review, the project collaborated closely with the Ministry of Health and Social Services (MoHSS), the Management Sciences for Health (MSH), Center for Disease Control and Prevention (CDC), the World Health Organization (WHO), Community Based Organizations (CBOs), and various other TB/HIV stakeholders. The project is operating in seven priority regions and eight urban hotspots, effectively having a presence in 12 of the 14 regions of the country, covering 25 out of 35 districts nationally, which represent 80% of the persons in need of TB/HIV care and prevention. Significant key outcomes/results were noted, including improved access to quality-assured patient-centered care for TB, TB/HIV, and MDR-TB services. The project has strengthened implementation of activities, especially in the CTB-supported regions/districts, and CTB staff have been actively involved in capacity building and improvement in quality of care. At least four CTB districts consistently maintained TB treatment success rates of above 90% throughout the year. The project has also optimized the utilization of DOT containers, which were procured under TB CARE I project, and has decentralized anti-retroviral therapy (ART) for stable patients to TB DOT containers. In Engela district, a total of 2,721 stable PLHIV originally receiving their ART at Engela District Hospital are now receiving ART from six TB DOT points. This decentralization approach will be rolled out in other three CTB districts in APA3, and the plan is to roll out the initiative in other CTB regions in APA3, targeting three districts and beyond that, targeting the rest of CTB and nationally in APA4. The project has also supported a total of 580 Healthcare Workers (HCW) with training on various technical areas, including a training of 30 Community Health Workers and 149 Field Promoters to strengthen TB/HIV Co-management. The project has also conducted training of MoHSS regional staff as well as newly engaged regional CTB staff on guidelines for the management of TB and TB/HIV and provided on-the-job training through mentorship and supportive supervision. The project has also conducted operational research studies to inform programmatic decisions and improve the quality of care for TB, TB/HIV, and MDR-TB patients. The project has also strengthened the capacity of the National TB and Leprosy Program (NTLP) and the National AIDS Control Program (NACOP) to manage TB and HIV programs, and has improved the quality of care for TB, TB/HIV, and MDR-TB patients. The project has also improved the availability and accessibility of TB and HIV services, and has increased the number of TB and HIV patients accessing care. The project has also improved the quality of care for TB, TB/HIV, and MDR-TB patients, and has strengthened the capacity of healthcare workers to provide high-quality care for TB, TB/HIV, and MDR-TB patients.