TB CARE I - Nigeria Annual Report Year 2

The NTBLCP is implemented in 36 states of the Federation, including the Federal Capital City (FCT), Abuja. TB CARE I worked in 26 out of the 36 states, including the FCT. The project's main goal was to support the NTBLCP and improve on the results achieved under the previous plan, APA 1. TB CARE I provided technical support in five technical areas: universal access to TB diagnosis, treatment, and care; laboratory strengthening; scaling up programmatic management of drug-resistant tuberculosis; health system strengthening; and strengthening the M&E and surveillance system of the NTBLCP. The project collaborated with various partners, including Family Health International (FHI 360), Management Science for Health (MSH), and the World Health Organization (WHO). One of the key achievements in universal access was the training of 234 Generalized Community Health Workers (GCHWs) from six states to provide DOTS services in 120 private healthcare facilities. Although there was limited time for supervision and monitoring, available data showed an improvement in the number of cases reported in the new facilities from 15% to 21%. Additionally, SOPs and job aids were developed, and 302 healthcare providers were trained on the SOP-approach and utilization of these tools at service delivery points, leading to a 6% increase in TB case notification over the target of 15%. Laboratory strengthening was also a key area of focus, with the expansion of Xpert MTB/RIF intervention to six more states. As a result, 2,009 MDR suspects were tested, of which 610 TB patients were diagnosed, with 201 being RIF-resistant. However, low cartridge utilization due to poor logistic management of sputum samples posed a challenge, which was addressed through discussions with the Round 9 GF PR for MDR-TB. Programmatic Management of Drug-Resistant TB (PMDT) was another key area of focus, with the development of human resources capacity for suspecting, notifying, and uploading investigation results using e-TB manager in Nigeria. The NTBLCP can now report data on diagnosis and management of DR-TB patients. The project also contributed to health system strengthening, with a focus on building the capacity of community-based organizations (CBOs) to implement TB/HIV activities in communities and among vulnerable groups. The total buy-in of USD 5.755M was appropriated for the implementation of activities by the coalition partners. Despite the challenges faced, including a shortened implementation period, competing NTBLCP activities, commodities and logistics management, and insecurity in parts of the country, significant achievements were attained. The Patients' Charter for Tuberculosis Care was implemented, with TB personnel being trained on the use of the charter in the last year. The scoring for this indicator is based on the revised M&E Plan, which specifies the scoring for each figure. This is to enable a proper assessment of the true picture. The number of private providers collaborating with the NTP increased, with 3 private providers collaborating with the NTP in 2007, and 3 in 2011. The percentage annual increase in case notification in selected PPM facilities also increased, from 15% to 21%.