TB CARE I - Uganda Year 2 Quarterly Report October-December 2012

The reporting country is Uganda, with technical areas including Universal and Early Access, TB/HIV, and Health Systems Strengthening. The lead partner is the National Tuberculosis and Leprosy Programme (NTLP), with collaborating partners such as the World Health Organization (WHO) and the Ministry of Health. The overall work plan implementation status is 75%, with a 5% decrease from the previous quarter. The main achievements include the completion of the National TB Strategic Plan and the National TB Program Implementation Plan. The plan outlines the NTLP's objectives, strategies, and activities for the period 2012/13-2014/15. In the Universal and Early Access technical area, support supervision visits were conducted in 35 health facilities, focusing on recording, reporting, and requisitioning of anti-TB drugs. The visits were led by a team of technical officers from TB CARE I, the Kampala City Council Authority (KCCA) TB Control Officer, and division TB supervisors. The team identified several challenges, including the need for sustained joint support supervision visits, improved recording and reporting, and the operationalization of electronic TB registers. The Programmatic Management of Drug-Resistant TB (PMDT) technical area saw the renovation of the Mulago MDR TB ward commence in October 2012. The renovation is scheduled to be completed in February 2013, with a total bed capacity of 30 MDR TB patients. A PMDT technical assistance mission was conducted by Dr. Max Meier of the PMU TB CARE I, with recommendations for architectural works for MDR TB wards at Mulago, Mbarara, and Fort Portal hospitals. In the TB/HIV technical area, TB CARE I supported the quarterly TB/HIV National Coordination Committee meeting. The discussion centered on the implementation of isoniazid preventive therapy (IPT) and the rollout of treatment for MDR TB across the country. The committee revised and updated the terms of reference for working groups and a list of organizations to be considered for membership. The Health Systems Strengthening technical area saw the finalization of the National TB Strategic Plan and the National TB Program Implementation Plan. The plan outlines the NTLP's objectives, strategies, and activities for the period 2012/13-2014/15. The plan was reviewed by stakeholders, including the Ministry of Health, and has been forwarded to the NTLP program manager for use in the remaining six months of 2013. Technical Area Results: * Universal and Early Access: 35 health facilities were visited, with a focus on recording, reporting, and requisitioning of anti-TB drugs. * TB/HIV: 3 TB/HIV National Coordination Committee meetings were held, with a focus on IPT and MDR TB treatment rollout. * Health Systems Strengthening: The National TB Strategic Plan and the National TB Program Implementation Plan were finalized and reviewed by stakeholders. Challenges and Next Steps: * Transition of KCCA leadership from city to capital city continues to pose a challenge in implementation, with KCCA staff, especially division TB supervisors, unsure of their positions and roles. * TB CARE I has trained and oriented additional health workers to provide TB support to health facilities, where division supervisors are not yet appointed. * Efforts to have clearance from the Ministry of Health's e-health review committee to send SMS for treatment adherence to TB patients were initiated, with next steps including engagement with MoH in discussions to implement the strategy. * The procurement of beds for Mulago TB Ward renovations was deferred until the renovations commenced, with next steps including procurement of beds in the next quarter. * The second round of Joint TB/HIV support supervision visits will be conducted in January-March 2013. * An additional 21 health workers were trained in TB management and control, with 6 males and 15 females currently supporting health facilities.