TB CARE I - Uganda Year 2 Quarterly Report April-June 2012

The overall work plan completion stands at 30%, with technical and administrative challenges affecting the implementation rate. In the Universal and Early Access technical area, support supervisions were conducted in Kampala, with a team of technical officers visiting 19 out of 38 health facilities. The team focused on on-site support supervision and on-job mentorship in areas such as TB patient management, TB/HIV, laboratory, recording, and reporting. Key issues identified include low DOTs implementation, low uptake for ART, poor TB IC practices, and inconsistent recording and reporting. The Programmatic Management of Drug Resistant TB (PMDT) technical area saw the process to start Mulago ward renovation underway, with a local consultant identified through competitive bidding and contracted. Fifteen Mulago staff were trained on MDR TB patient management and care in preparation for starting ambulatory treatment for drug-resistant patients next quarter. In the TB/HIV technical area, joint TB/HIV support supervision visits were conducted in 3 NTLP Zones, with technical staff of TB CARE I, National TB/Leprosy programme (NTLP) staff, and implementing partners participating. Key issues identified include low uptake of ART for TB/HIV patients, poor infection control practices, and unclear messages on IPT implementation. The Health Systems Strengthening technical area saw the Uganda STOP TB Partnership meeting funded by TB CARE I Uganda, with several Technical Working Groups formed to increase momentum of implementation, monitoring, and evaluation of TB-related activities in Uganda. Challenges faced during the quarter include lengthy procurement processes, bureaucratic processes, and community engagement issues. A total of USD 1.4M was released for the April-June 2012 activities, with the bulk spent on procurement of Anti-TB medicines. The Quarterly Technical Outcome Report highlights the progress made in various technical areas, including Universal and Early Access, PMDT, and TB/HIV. Key indicators such as the number of facilities covered by support supervision visits, the number of defaulters receiving monthly SMS for treatment adherence, and the number of diagnosed MDR-TB patients enrolled on treatment are reported. The report also highlights the challenges faced in various technical areas, including the delay in procurement of MDR TB drugs, the delay in renovation of the MDR TB ward in Mulago, and the lack of community engagement. Next steps to address these challenges are outlined, including the procurement of 100 courses of MDR TB drugs, the initiation of renovation of the MDR TB ward, and the stepping up of enrollment of MDR TB patients. Overall, the report highlights the progress made in various technical areas, despite the challenges faced. The next quarter is expected to see significant progress in the implementation of various activities, including the renovation of the MDR TB ward and the enrollment of MDR TB patients.