TB CARE I - South Sudan Year 3 Quarterly Report October-December 2012

The project's overall work plan completion rate stands at 81%, with notable achievements in several technical areas. In the Universal and Early Access technical area, the project has made substantial progress in integrating TB services into primary health care facilities. The Duk Lost Boys' Clinic in Jonglei state has been identified as a model for integrating TB services, and the facility is expected to start reporting TB cases in January 2013. The project has also seen a significant reduction in primary defaulters in Juba county, from 32% in April-June 2012 to 13% in July-September 2012. The project has also made progress in laboratory services, with the National TB Program (NTP) lab team reviewing the current lab SOPs to conform to international quality management standards. The project has procured 11 sets of microscope kits, equipment kits, consumable kits, and sputum containers, which were received on December 14, 2012, and handed over to the NTP on December 17, 2012. In the TB/HIV technical area, the project has conducted a 3-day training for 25 VCT counselors from Eastern Equatoria State, introducing the standardized TB screening tool. The project has also established referral mechanisms for TB screening tools that were jointly revised by the TB and HIV working groups. The project has also participated in the 43rd UNION Conference in Kuala Lumpur, Malaysia, presenting two symposium papers and a poster presentation on integrating TB into primary health care in South Sudan. Despite these achievements, the project faces several challenges, including the current GF grant supporting TB control expiring in December 2013, which has led to the NTP applying for TB TFM grants to start in January 2014. The project also faces challenges related to human resources, particularly in the laboratory sector, where the team had to stop working on reviews due to constraints relating to availability of personnel. The project's quarterly technical outcome report highlights several technical areas, including Universal and Early Access, Laboratories, and TB/HIV. The report shows that the project has made progress in increasing TB case notification, improving the quality of laboratory services, and strengthening prevention of TB/HIV co-infection. However, the project faces challenges in several areas, including late reporting by health facilities, improving communication with health facilities, and addressing the gap in the strategic plan for implementing laboratory services. The project also faces challenges in improving treatment success of MDR-TB, referral of samples, and MDR TB case management. Overall, the TB CARE I project in South Sudan has made significant progress in several technical areas, but faces several challenges that need to be addressed to achieve the project's expected outcomes.