TB CARE I - Zambia Year 3 Annual Report October 1, 2012 –September 30, 2013

The project has provided support to the Ministry of Health (MoH) and the Ministry of Community Development Mother and Child Health (MCDMCH) in key focus areas of TB control and TB/HIV collaborative activities during the third year of project implementation. FHI360 led the implementation of project activities, partnering with KNCV Tuberculosis Foundation, Management Sciences for Health (MSH), and the World Health Organization (WHO). TB CARE I Zambia expanded project support to the National TB Control Program (NTP) to two new provinces in the country, Lusaka and Southern provinces. The project also collaborated with the Centre for Infectious Diseases Research in Zambia to implement activities in four of the ten provinces. TB CARE I received $4,396,000 from USAID and additional PEPFAR funding in the amount of $1,957,526 for the WHO 3Is. The project carried over funds from year two of project implementation to support the procurement of equipment and commodities for Zambia's first national TB prevalence survey. TB CARE I achieved key results by technical area, including increased quality of TB services delivered among all care providers, scaled-up implementation of TB infection control strategies, and improved diagnosis of TB/HIV co-infection. In the area of Universal Access, TB CARE I provided support to the NTP for DOTS strengthening and enhancement through training of 992 people, including 110 prison service providers, 50 prison inmates, and 127 traditional healers. The project also contributed to the development of a national Advocacy Communication and Social Mobilization (ACSM) strategy, providing technical support through an ACSM consultant from the KNCV Tuberculosis Foundation in May 2013. TB CARE I supported the implementation of TB infection control strategies, with 35 facilities receiving support in developing TB IC plans. Among these facilities were six prisons, including two from the sites supported by CIDRZ. These IC plans have been integrated into the 2013-2014 annual action planning cycle for these activities to receive funding from government. A total of 742 healthcare workers, including 74 prison officers, from these facilities received orientation in TB infection control this year. In the area of TB/HIV, TB CARE I contributed to improved diagnosis of TB/HIV co-infection through the support towards establishment of ART services in TB clinics. The project supported two female technical staff from the MCDMCH Kitwe and Mkushi district medical offices to attend the 1st International TB/HIV course focusing on the "TB/HIV ONE STOP SHOP" concept in Kigali, Rwanda from July 22-26, 2013. Upon their return, they spearheaded the establishment of ART services in TB clinics. TB CARE I also enhanced collaborative TB/HIV activities through the implementation of the WHO 3Is Initiative, a three-year project that focuses on intensified case finding, infection control, and isoniazid preventive therapy. Under the WHO 3Is initiative, the project installed seven GeneXpert machines in five districts of the two target provinces, conducted facility baseline assessments in all 18 target sites, and trained healthcare workers, prison service providers, and community volunteers who will lead the ICF activities. In the area of Monitoring and Evaluation, Surveillance, and Operations Research, TB CARE I provided support for the first national prevalence survey that began in September 2013. The project procured equipment and commodities for the survey, including three Mycobacterium Growth Indicator Tube (MGIT) machines to support liquid culture in the three reference laboratories, and digitalization of three mobile x-ray machines. The project also hosted 50 participants to the national TB/HIV Leprosy data review meeting held in September 2013. The Ministry of Health (MoH) in Zambia has been restructured into two ministries, the MoH and the Ministry of Community Development Mother and Child Health (MCDMCH). The MoH has provided national and provincial level support, while the MCDMCH has focused on district to community level care. TB CARE I has partnered with the two ministries to support the National TB Control Program (NTP) activities from national to community level. The TB CARE I partnership in Zambia is led by FHI360, with other in-country partners including the World Health Organization, Management Sciences for Health, and KNCV Tuberculosis Foundation. The project total obligation to date is $17,373,000, and the staff members under the project have expanded from twenty in 2012 to forty this year.