TB CARE I - Mozambique Year 2 Quarterly Report

The project's overall work plan completion stood at 86% by the end of the reporting quarter. The project's technical areas, including Universal and Early Access, Laboratories, Infection Control, PMDT, TB/HIV, Health Systems Strengthening, and Malaria, made notable progress. In the Universal and Early Access technical area, a total of 785 community-based DOTS (CB DOTS) volunteers, 358 traditional healers, and 150 health technicians were trained during the reporting quarter. These trained activists referred 10,880 TB/Malaria suspects to health facilities, resulting in 1,893 TB diagnoses, including 445 TB/HIV positive cases. The project also supported the National Tuberculosis Program (NTP) in reviewing the Pediatric TB manual, which will be finalized by the end of the year. In the Laboratories technical area, a five-day training on quality assurance, biosafety, laboratory management, and new technologies (GeneXpert, LED microscopy, and Line Probe Assay) was conducted for 11 reference laboratory staff. The training resulted in the development of work plans for improving the quality of TB laboratory diagnosis. A total of 1,040 AFB smear microscopy manuals were printed and distributed nationwide, and 18 LED microscopes were procured and installed in 18 sites, with laboratory technicians trained on their use and maintenance. The Infection Control technical area made significant progress, with 174 performance evaluation instruments (IMD) printed to measure the implementation of IC activities in four selected provinces. The project also supported the NTP in developing a draft national genexpert algorithm, which was approved for pilot use in the country. In the PMDT technical area, several meetings were held to finalize the PMDT strategy for Mozambique, resulting in the finalization of the final draft, which was submitted for consultant review and approval by the NTP. The project also conducted clinical trainings in TB/HIV in two TB CARE I provinces, Sofala and Zambezia, with a total of 60 MOH health staff attending the trainings. The Health Systems Strengthening technical area made significant progress, with the annual TB CARE I meeting with CB DOTS implementing agencies conducted, where all CB DOTS implementing agencies were represented. The meeting objectives were to evaluate the implementation of CB DOTS activities, share challenges, lessons learned, and new implementation strategies to improve and strengthen CB DOTS activities. The project also conducted a three-day workshop on TB, TB/HIV, MDR TB, and Pediatric TB directed to all TB and HIV partners at provincial level, with FHI360 staff from the TB CARE I project, CHASS Niassa, and CHASS SMT projects, as well as representatives from other partners, attending the workshop. The Malaria technical area made significant progress, with the malaria communication strategy finalized with support from WHO and the National Malaria Control Program (NMCP). The strategy is being translated into Portuguese for final signature approval by the Minister of Health. Malaria clinical management trainings were conducted in Cabo Delgado, Tete, and Manica provinces, with a total of 983 clinicians trained. The project implementation status is now at 86%, and the team is determined to have the work plan and budget approved in time for APA3 to avoid the constraints faced in APA2. Procurement still poses a challenge, and the team has learned to initiate all procurement at the start of the budget year to avoid reporting of accrual funds at the end of each reporting quarter. The Global Fund has disbursed funds for the purchase of first- and second-line drugs, and the transitional funds mechanism proposal has been approved under category three for Mozambique. Technical support in the development of the proposal was provided by the TB CARE I project through a KNCV-based consultant. The proposal also covers the procurement of drugs for TB. The quarterly technical outcome report highlights the project's achievements in increasing demand for and use of high-quality TB services and improving the satisfaction with TB services provided. The piloting of patient-centered approach (PCA) tools was conducted in two selected districts of Nampula and Chibuto, with a total of 12 nurses, 26 CB DOTS volunteers, and 3 IAs trained. A total of 2,280 patient charters copies, 36 TB literacy booklets, 36 teaching aids, 18 quote TB light booklets, and 12 sets of quote TB pictogramas were distributed to be used by volunteers and health technicians in disseminating PCA information and the patient charters to TB patients.