Quarterly Report: Afghanistan, Year 1, July - September 2011

The project, led by Management Sciences for Health (MSH), aims to improve the quality of TB services delivered among all care providers in Kabul and 13 provinces through the implementation of Universal and Early Access, Laboratories, Infection Control, and Health Systems Strengthening. The report indicates that the TB CAP project for Afghanistan completed on June 30, 2011, and transitioned smoothly to TB CARE I. The new management of TB CARE I extended the level of assistance to the National Tuberculosis Program (NTP) and shifted all staff to the NTP. TB CARE I assists the NTP on DOTS expansion to urban and rural areas under Urban DOTS and Community-Based DOTS (CB-DOTS). The report highlights several key achievements, including the implementation of TB suspect management and case findings, refresher and initial training for health facility staff, community events to increase awareness of TB and reduce stigma, and the strengthening of tuberculosis infection control measures. The project also conducted quarterly review workshops in seven provinces, training 350 individuals in basic data analysis, interpretation, and feedback. The report also presents the technical outcome report for the first year, which includes indicators for increased quality of TB services delivered among all care providers in Kabul and 13 provinces through CB-DOTS. The indicators include the number of new sputum smear-positive TB cases diagnosed by Urban DOTS health facilities and the number of new sputum smear-positive TB cases out of TB suspects referred by community health workers. The report also highlights the challenges faced by the project, including the slow implementation of activities due to Ramadan and Eid in August 2011 and insecurity in some provinces. The project is requesting a one-month no-cost extension to accomplish the remaining activities. The report also presents the quarterly activity plan report, which includes the lead partner, approved budget, cumulative completion, and month and year for each technical area. The report highlights the progress made in each technical area, including Universal and Early Access, Laboratories, Infection Control, and Health Systems Strengthening. Overall, the report provides an overview of the progress made by the TB CARE I project in implementing the work plan for the first year and highlights the achievements, challenges, and next steps for the project.