TB CARE I - South Sudan Year 2 Quarterly Report January - March 2012

The project is led by Management Sciences for Health (MSH) and has collaborating partners, including KNCV and the World Health Organization (WHO). The project's technical areas include Universal and Early Access, Laboratories, Programmatic Management of Drug-Resistant TB (PMDT), TB/HIV, and Health Systems Strengthening (HSS). In the Universal and Early Access technical area, TB CARE I supported the National TB Program (NTP) to improve the quality of TB services by strengthening the capacity of health workers to diagnose and treat TB through trainings. Twenty health workers were trained on TB diagnosis and treatment in Kwajok, Warrap state, which will improve early access to TB treatment. The TB strategic plan 2013-2017 was also revised to ensure that TB control is embedded as a priority disease in the country with commensurate domestic financing and engagement of partners. In the Laboratories technical area, a senior lab advisor is on board, and a TB IQC and EQA plan has been developed for the next 6 months. Baseline data on laboratory services has been collected, and a monitoring tool has been developed. IQC has been established in 3 laboratories in Juba County, and on-the-job training and mentorship on IQC and EQA of the lab focal persons at central level and Juba Teaching Hospital is ongoing. Assessment has been completed in 3 out of 7 laboratories that require refurbishment, and procurement of lab equipment and supplies is ongoing. In the PMDT technical area, MDR-TB has been confirmed in 6 patients in South Sudan out of 66 from whom samples have been sent to CRL in Nairobi, Kenya. TB CARE I continues to support the NTP to send samples to Nairobi for culture and DST. TB/HIV technical area saw TB CARE I supporting the World TB Day celebrations in Torit, Eastern Equatoria State, and disseminating TB/HIV messages nationally and locally using local FM stations. In the HSS technical area, the framework for integrating TB services developed through TB CARE I has been used to assess PHCCs for refurbishment. The tool has been used to identify 3 PHCCs that will be refurbished in the coming quarter. The tool will be shared through the NGO health forum to be sent to partners, which will help identify health facilities for integration of TB services and those that require refurbishment. TB CARE I also provided technical assistance to South Sudan to develop their Global Fund Transition Funding Mechanism (TFM) proposal. The proposal has four main objectives, six service delivery areas, and 14 activities, with a total budget of USD 9.3 million for two years. The performance framework with clear indicators was also developed, and the proposal was presented in an ad-hoc CCM meeting on 6th March 2012. The quarterly technical outcome report highlights the progress made in the technical areas, including the implementation of the CB-DOTS program, increase in TB case notification, ensured capacity and availability of laboratory testing, improved treatment success of MDR-TB, strengthened prevention of TB/HIV co-infection, and improved diagnosis of TB/HIV co-infection. The report also highlights the challenges and next steps to reach the targets in each technical area.