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

The report emphasizes the importance of community-based approaches to TB management and control, with a focus on increasing TB case notification, improving health service delivery, and enhancing access to diagnosis. The report notes that the Control Officers Retreat, held in the current quarter, was a significant achievement, as it brought together Control Officers from various states to discuss their program performances and agree on strategies for improvement. The retreat focused on team building, effective control officer performance, and financial accountability. The Control Officers vowed to improve on general office management, supervision, and reporting of data, with a plan to report back to the general house during the planned Control Officers Meeting in November. The report also highlights the organization of monthly mentoring visits to challenged states, which focused on general office management, development of organograms and job descriptions, filing systems, store management, and data analysis. These activities demonstrate a coordinated upstream support to the National Tuberculosis and Leprosy Control Programme (NTBLCP) at all levels. In addition, the report notes that a Senior Lab Consultant from the TB CARE I Project Management Unit (PMU) visited Nigeria from August 1-10, 2011, to finalize training materials and supporting documents for the GeneXpert Pilot Project. The visit resulted in a comprehensive action list, including the development of a basic computer module, finalization of national MDR TB guidelines, and follow-up meetings to finalize the curriculum and logistics plan. The report also emphasizes the importance of laboratory strengthening, with a focus on improving the quality of laboratory services. A 3-day training was organized for 42 laboratory personnel on biosafety measures required to work in a BSL3 TB culture laboratory or BSL2 with BSL3 practices. Furthermore, a 3-day capacity-building activity was conducted for 64 laboratory personnel on good clinical practice required to work in a TB laboratory. The report highlights the organization of an expert meeting to review the National ACSM guidelines and develop ACSM toolkits and IEC materials. The meeting brought together representatives from various organizations, including WHO, SFH, FHI, TB-CARE, and the National TB Network. The key outcomes of the meeting included linking up effectively ACSM activities with the national program, involving program managers in all ACSM activities, and ensuring access to harmonized and updated ACSM tools and materials. The report also notes that a reconnaissance visit was conducted to assess the feasibility of introducing e-TB manager for the management of MDR-TB. The assessment aimed to introduce e-TB manager to interested parties and assess the feasibility of implementing e-TB manager for MDR-TB case management and second-line drug management in Nigeria. The assessment concluded that most of the resources required for the implementation of e-TB manager are available in Nigeria, and if the key challenges of power and internet connectivity are addressed, e-TB manager implementation is possible in Nigeria. The overall implementation status is 50%, with several factors contributing to the delay, including the UN bomb blast and renovation activities of FHI. The coalition partners have agreed to ensure full attention to speeding up the process of implementing activities before December 31st, 2011. The report emphasizes the importance of planning activities alongside the general activities from the National Tuberculosis and Leprosy Control Programme (NTBLCP). The TBCARE I Nigeria approach is to ensure that the NTBLCP takes the lead in the implementation of all project activities, requiring numerous discussions with the NTBLCP and various partner organizations. The report concludes by highlighting the achievements and challenges in the implementation of the TB CARE I project in Nigeria. The project has made significant progress in increasing TB case notification, improving health service delivery, and enhancing access to diagnosis. However, several challenges remain, including the delay in implementation and the need for further planning and coordination with the NTBLCP and partner organizations.