TB CARE I - South Sudan Year 2 Quarterly Report

Collaborating partners, including KNCV and the World Health Organization (WHO), contributed to the initiative's progress. The report highlights several key achievements, including the development of Patient Center Treatment (PCT) guidelines, which will provide a framework for implementing community-based DOTS in South Sudan. The PCT guidelines have been drafted and are awaiting approval from the National TB Program (NTP) before printing and dissemination can be done. Joint supervision and mentorship have continued to strengthen the integration of TB services, with four TB diagnostic and treatment centers benefiting from joint supervisory visits. The central and state-level TB staff have also been mentored on the PCT approach. In the Laboratories technical area, TB CARE I has continued to strengthen TB laboratory networking and establishing quality assurance systems in South Sudan. Follow-up visits were carried out to four centers in the greater Yei region by a joint supervision team composed of TB CARE I Lab advisor, State TB coordinator, and the two NTP lab coordinators. Supervision and mentorship included bench training and role plays. The Yei Civil hospital lab staff, which serves as a role model, has made significant progress in integrating TB into general lab routine work by adding other aspects of quality assurance into their routine. The TB Infection Control (TBIC) technical area has seen significant progress, with the development of the first TBIC guidelines through the support of a KNCV consultant. The guidelines have been developed through a desktop review of program documents, visits, and assessment of TBIC activities in various facilities in South Sudan, including prisons and military barracks. A one-day workshop on TBIC was conducted at Juba Teaching Hospital, attended by 15 frontline TB workers in Juba. The Health System Strengthening (HSS) technical area has also made progress, with the Global Fund (GF) categorizing the TB Transition Funding Mechanism (TFM) proposal to Category 4, requiring revision of the proposal based on the Technical Review Panel (TRP) comments. A consultant was hired by the Program Management Unit (PMU) to support the revision process, and the proposal has been revised and presented to the Country Coordinating Mechanism (CCM) and endorsed. However, several technical and administrative challenges have been identified, including human resources challenges, infrastructure development, and competing priorities within the NTP. The current GF grant supporting TB control expires in December 2013, and the NTP has applied for TB TFM grants to start in January 2014. The overall work plan implementation status is about 76%. The quarterly technical outcome report highlights several key indicators, including the implementation of the CB-DOTS program, increase in TB case notification, and improved treatment success of MDR-TB. The report also highlights challenges and next steps to reach the target, including timeliness reporting, poor infrastructure development, and lack of test kits.