TB CARE I - Botswana Year 4 Quarterly Report April – June 2014

The program's senior technical advisor supported a research project on the evaluation of Community TB Care (CTBC) in Botswana. The study aimed to evaluate the effectiveness and acceptability of community TB care models implemented in the country and explore their sustainability. Preliminary results showed that CTBC approaches using incentivized volunteers were deemed the most effective and associated with quality, despite poor sustainability. CTBC approaches managed by Civil Society Organizations were noted to be significantly effective for hard-to-reach populations and acceptable. The program also supported the development of the addendum to the current TB Strategic Plan 2013-2017, in line with the WHO post-2015 TB strategic plan and the Global Fund New Funding Model requirements. The senior technical advisor supported epidemiological and impact analysis (Epi-analysis) and TB program desk review, as well as the single TB/HIV concept note development. The draft scope of the concept note was developed and shared with the CCM and Global Fund Country Team in Geneva. TB CARE I also supported the closure of the previous Round 5 Global Fund TB grant and transitional funding mechanism (TFM). The program supported the ongoing GeneXpert roll out, with GeneXpert machines installed in 33 health facilities covering all 28 health districts across the country. The remaining one Xpert machine was scheduled to be installed during the 4th quarter. The program also supported training of staff, selection of appropriate location, and deployment of the machines at the health facilities. In terms of technical outcomes and activity progress, the program reported good progress in increasing coverage of Community TB Care, with a target of 90% coverage by the end of Year 4. The program also supported the National TB Reference Laboratory (NTRL) in maintaining its accreditation to ISO 15189 international Standard from the South African National Accreditation Systems (SANAS). The program supported the roll out of GeneXpert, with 33 health facilities equipped with the machines, and supported the strengthening of culture and DST at NTRL. The program also supported MDR treatment sites, with one round of mentoring completed.