TB CARE I - Afghanistan Year 3 Quarterly Report January-March 2013

The project is led by Management Sciences for Health (MSH) and collaborates with the National Tuberculosis Program (NTP) and other stakeholders. The project's overall goal is to improve TB control and prevention in Afghanistan. TB CARE I has made significant progress in identifying TB cases, particularly in the intervention areas. In 2012, 2,280 more TB cases were identified compared to the rest of the 21 provinces. Additionally, TB CARE I identified 8.7% more smear-positive cases and 27.1% more TB cases compared to the baseline level of 2009. The project also achieved a 7% improvement in treatment success rate in Afghanistan. The project has implemented various activities to improve access to TB services. In the reporting period, TB CARE I subcontracted community-based Directly Observed Treatment Short Course (DOTS) with NGOs in six provinces and drafted the scope of work for CB-DOTS in the remaining seven provinces. During this period, 1,930 TB suspects were identified by community health workers, 170 turned out to be sputum smear-positive TB, and 508 TB patients received their DOT from CHWs. TB CARE I has also strengthened the health system by assisting the NTP conduct World TB Day in 13 provinces and in 300 health facilities. The project developed and disseminated 80,000 TB brochures, aired TB messages to over 100,000 people, and recognized the work of 145 high-performing health facilities and community health workers. An estimated audience of 113,500 direct and 1,000,000 indirect participants was reached. The project has also made progress in infection control, with the TBIC plan integrated into 22 new health facilities this quarter. The TBIC committee meetings were conducted at national and provincial levels, with 1800 healthcare staff attending. The project has also expanded TB-IC measure application to 26 new health facilities in all 13 USAID-supported provinces. TB CARE I has also implemented various activities to strengthen TB control components, including drug supply and management, laboratories, community care, HRD, and M&E. The project has assisted the NTP conduct a workshop on the Data Analysis version of TBIS and assisted the NTP to monitor TBIS implementation. The project has faced technical and administrative challenges, including rapid implementation and staff turnover. The project has coordinated with the NTP to enhance the implementation process and has planned to decrease staff from 11 to 7 members by the end of June 2013. The project has also received approval for the Global Fund Round 8 phase II and has begun the implementation process. Overall, TB CARE I has made significant progress in improving TB control and prevention in Afghanistan. The project has implemented various activities to improve access to TB services, strengthen the health system, and improve TB control components. However, the project faces challenges related to rapid implementation and staff turnover, which need to be addressed to ensure the project's success.