TB CARE I - Namibia Year 2 Quarterly Report January-March 2012

The project's overall work plan completion stood at 29% as of January-March 2012. Key achievements included the signing of the Global Fund Round 10/Round 2, Wave 7, Rolling Continuation Channel (RCC) under single-stream funding (SSF), which secured US$12 million for the first phase. World TB Day commemorations were successfully held in Windhoek, and a TB National Steering Committee meeting was convened with TB CARE I support. TB Infection Control (TB-IC) training for focal persons at state hospitals was funded by TB CARE I. The project continued to provide technical support to the National TB Program (NTLP) in coordinating and participating in management of DR-TB patients through the weekly Central Clinical Review Council (CCRC) meetings. Planning for an international DR-TB training, organized by The Union, in collaboration with NTLP and KNCV TB Foundation, Namibia Country Office, had already started. TB/HIV activities included the successful application for OGAC funding for a TB/HIV proposal, worth nearly USD6 million for a period of three years. This demonstration project will be implemented in four districts of Namibia. Several TB/HIV technical working group meetings were held to plan implementation of this project. The project also focused on Health Systems Strengthening (HSS), with regular KNCV field office staff meetings and weekly TB CARE I meetings for Country Representative officers improving project follow-up and monitoring implementation of Action Plans. Meetings with the NTLP increased levels of cooperation between the two entities. Recruitment and training of Field Promoters engaged in Community-Based TB Care (CBTBC) services in Karas and Erongo region were conducted, with a total of 22 field promoters trained this quarter. In terms of Monitoring and Evaluation (M&E), OR and Surveillance, program management and data quality support visits to identified districts and regions were done with support from TB CARE I. Khomas region was supported through a targeted supportive supervision aiming to improve data quality and other aspects of program management. Feedback sessions were given after the visits. The state of implementation of TB CARE I planned activities was encouraging, standing at 29%, and was promising to be good throughout the year. Good collaboration with the NTLP was the main recipe for this good state of implementation of activities. Abrupt discontinuation of Global Fund resources to community-based TB care organizations disrupted some activities during this quarter, and TB CARE I had to provide gap-filling funds to organizations such as CoHeNa (Omaheke), Penduka (Khomas), and Health Unlimited in Otjozondjupa regions. The Global Fund approved a total of US$31.6 million for NTLP, of which US$1.9 million was disbursed in early 2012. However, there were a lot of conditions attached to the budget, making implementation as per the original plan drawn out in the approved proposal difficult. Challenges facing the implementation of Global Fund ranged from limited capacity at Programme Management Unit (PMU)/GFATM/MoHSS to staff attrition at facility level as a result of salary cuts across the board. TB CARE I continued to provide technical support to the NTLP in coordinating and participating in management of DR-TB patients through the weekly Central Clinical Review Council (CCRC) meetings. The project also supported the NTLP TB-IC focal person's travel to Otjozondjupa region to facilitate in TB a training on congregate settings in collaboration with ITECH and other stakeholders. The project's quarterly technical outcome report highlighted several key results, including increased demand for and use of high-quality TB services and improved satisfaction with TB services provided. The report also noted that the CB-DOTS program was implemented, and capacity building of healthcare workers was conducted, with 47 field promoters and 6 supervisors trained in 2011, and 22 field promoters trained in Erongo this quarter.