TB CARE I - Uganda Annual Report Year 2

The project focuses on four priority areas: Universal Access, Programmatic Management of Drug Resistant TB (PMDT), TB/HIV, and Health Systems Strengthening (HSS). The project aims to enhance leadership and technical capacity of NTLP to effectively guide and manage implementation of TB control activities at national and district levels. TB CARE I also supports the implementation of DOTS in Kampala, provides technical assistance for the coordination and implementation of comprehensive TB/HIV and DOTS interventions, and strengthens NTLP capacity to initiate a quality MDR TB program. In the area of Universal Access, TB CARE I is supporting DOTS implementation in Kampala to ensure increased quality of TB services delivered in health facilities. The project is working closely with the Kampala Zone TB supervisor, division supervisors, and the KCCA TB Control Officer to conduct targeted support supervision and mentorship visits to health facilities in Kampala. Key achievements in the Universal Access area include a 19% increase in the number of facilities in Kampala covered by support supervision visits, from 8/36 in 2011 to 19/38 in the first year of the project. Additionally, the project has supported the implementation of monthly phone call reminders to treatment interrupters/defaulters, which has contributed to a decrease in the default rate from 34% to 21% within the first six months of implementation. In the area of PMDT, TB CARE I has supported the enrollment of 24 MDR TB patients onto treatment in the three sites of Mulago, Kitgum, and Arua. The project has also trained healthcare workers in MDR TB, procured fridges for storage of drugs, and formed National and hospital-based PMDT panels. The renovation of the Mulago MDR TB ward is underway. TB CARE I has also strengthened partner coordination at the national level by supporting the reactivation of the TB/HIV National Coordination Committee. Joint TB/HIV support supervision visits to nine NTLP zones have been conducted to improve TB/HIV collaborative activities. In the area of HSS, TB CARE I is supporting NTLP to finalize the draft National TB Strategic Plan (2012/13-2014/15) and develop the annual implementation plan and supporting coordination mechanisms of NTLP. Despite challenges related to health systems, including inadequate human resources, drug stockouts, and poor recording and reporting, TB CARE I has made significant progress in improving TB control and management in Kampala. The project has also conducted an assessment of TB control and management in health facilities and divisions within Kampala, which has provided first-hand information about TB issues in Kampala and helped realign interventions to address the problems. In the remaining project period, TB CARE I will consolidate gains achieved in the four results areas and accelerate implementation in the areas lagging behind. The project will continue to support supervision to improve recording and reporting and subsequently TSR, complete the MDR TB ward in Mulago, and aim to support two additional sites of Kitgum and Mbarara to hasten enrollment of MDR TB patients.