TB CARE I - Ghana Year 2 Quarterly Report October-December 2011

Preliminary results show that out of 3,663 health facilities, 1,432 facilities provide some form of TB DOTS services, representing a 39% health facility DOTS coverage. In the public sector and faith-based health sector, 1,300 (45%) out of 2,918 health facilities provide DOTS services. Furthermore, out of 670 laboratories in the public and private sector, 282 (42%) provide smear microscopy services, representing one TB microscopy centre for every 85,106 people. The TB CARE I M&E Officer continued to support the NTP in analyzing quarterly data received from all 10 regions. During the quarter under review, he completed analyzing the July-September 2011 quarter, and the results show that 4,058 TB (all forms) were notified, almost the same as the first and second quarter TB case finding figures of 4,057 and 4,051 respectively. Out of the 4,058 TB cases notified during the third quarter of 2011, females constitute 1,539 (38%), and children under the age of 15 years were 228 (6%). The TB CARE I team also conducted monitoring visits to six hospitals in the Eastern region that report higher numbers of TB cases. The results show that in 2010, a total of 809,711 OPD clients accessed care in these facilities, and as low as 3,260 (0.40%) TB suspects had their sputum samples examined, and 422 (13%) were smear positive cases. The TB CARE I Country Director and the TB CARE I M&E Officer played a vital role in supporting the NTP in reviewing and updating TB Prevalence Survey Forms. The Ghana TB Prevalence survey is scheduled to be launched in April 2012. Additionally, they supported the NTP in reviewing the MDR-TB surveillance forms, which have since been finalized and are ready for printing. The overall work plan implementation at the end of the quarter was at 20%, with some delays in the commencement of planned activities due to a reduced work plan budget ceiling and the delay in signing the Global Fund Round 10 TB Grant. The TB CARE I Country Director continued to chair the HIV-TB Oversight Committee of the Ghana Country Coordinating Mechanism (CCM) and led a team that conducted a site visit to one of the Principal Recipients (PRs) of the existing Grants. The CCM hosted a one-day Stakeholders Forum on December 15, 2011, to receive updates from the main PRs of the existing Grants, including the NTP. The aim of this meeting was for the CCM to receive updates from the main PRs of the existing Grants that included the NTP. The PRs were briefed about the decision of the Global Fund Board meeting that took place in Accra in November 2011. The CCM reiterated that all PRs should now focus on high-impact interventions and essential prevention, treatment, and care services. The TB CARE I team also conducted initial visits to six big hospitals that report higher figures of TB cases in the Eastern region. The results clearly show that TB case detection activities are not systematically organized. A TB situation analysis to determine the exact health facility DOTS coverage in all the 10 regions of Ghana, including the Eastern region, was conducted, and a preliminary report is ready. This information will be useful for scaling up TB case detection interventions in the region. Five districts have been identified where TB case detection will be optimized, and training of healthcare workers will start in February. On-site training will be advocated for as opposed to the traditional method of hotel-based training. Training will include TB screening in PLHIV and TB Infection Control. The TB CARE I team also supported the NTP in developing and printing national TB guidelines. The guidelines have been finalized and printed. The TB CARE I team also supported the NTP in reviewing and updating TB Prevalence Survey Forms. The Ghana TB Prevalence survey is scheduled to be launched in April 2012. The overall work plan implementation at the end of the quarter was at 20%, with some delays in the commencement of planned activities due to a reduced work plan budget ceiling and the delay in signing the Global Fund Round 10 TB Grant.