The Eradicate Tuberculosis Project Quarterly Report October 2017 - December 2017

The project is a five-year initiative led by PATH and implemented in partnership with the Government of the Republic of Zambia, the National Tuberculosis Program, the private sector, and other stakeholders at the national, provincial, district, and community levels. The project focuses on four main tasks: pursuing high-quality DOTS expansion and enhancement, addressing TB-HIV, Multi-drug resistant (MDR) TB, and the needs of poor and vulnerable populations, engaging all categories of providers, and enabling and promoting research. The project's objectives are to increase the number of individuals screened for TB in the target provinces by 50 percent, thereby increasing the number of people diagnosed with TB, and to increase TB treatment success rate to 85 percent and beyond in the target provinces. The project will help strengthen components of the GRZ's response to ultimately eliminate TB in Zambia, consistent with the global End TB Strategy and Zambia's new National Strategic Plan for Tuberculosis Prevention, Care, and Control, 2017–2021. During the fourth quarter of 2017, the project achieved several key milestones. The Year 2 work plan was developed and submitted on December 20, 2017, and USAID provided feedback, which was addressed by the project and resubmitted for review and approval. The project finalized the recruitment and placement of all project staff, including Provincial TB Technical and Laboratory Specialists, and all staff have since been deployed. The project also supported the National TB Program in conducting a participatory rapid review of TB management human resources, where frameworks and tools for guiding a participatory review of HR management systems and action planning with NTP at national, provincial, and district levels were developed. The project strengthened the NTP field appraisal tool that captures data in relation to community awareness and TB-Care program, and the tool has been modified to integrate key performance aspects of the ETB-project. The project also conducted assessments to establish social support programs, structures in the community, current TB awareness activities, gaps or needs, potential sources of communication such as radio stations, and identified community stakeholders in the project districts that will support the implementation of TB activities. The project supported NTP in the review and finalization of the treatment supporter's manual and oriented THPAZ national and provincial leadership on ETB Community TB activities. Formation of former TB patients support groups has been done in 13 districts. The project also supported NTP in a rapid laboratory assessment and mapping exercise in preparation for development of a "new technology scale-up plan" based on existing national documents to inform GeneXpert machine. Support was also given to NTP on the Copperbelt Province to redistribute GeneXpert Cartridges from overstocked district laboratories to deficit areas. A GeneXpert training was conducted for participants from all the six ETB supported provinces. The project in collaboration with Challenge TB Laboratory Advisor and Copperbelt Provincial Biomedical Scientist conducted calibrations and replaced modules on the GeneXpert equipment at Ndola Teaching Hospital, Lubuto, and Chipokota Mayamba. Technical and Laboratory support to ETB supported districts of Luapula and Central Provinces were provided. The project jointly developed a Work plan for Quality Management Strengthening activities for ISO 15189, with NTRL. The project successfully conducted a validation workshop which was used as a platform to review the project data collection tools, as well as finalize on the NTP TB and MDR-TB data collection and reporting tools. The project's M&E unit developed an Indicator Protocol Reference Sheet that guided the collection of data at the diagnostic centers. The USAID ETB Operation Research (OR) team successfully completed the development of an eight (8) module OR training manual and together with the districts identified research priorities. All the six project vehicles have been branded and deployed to the six Provincial project sites. As order for 2 GeneXpert machines and 900 cartridges was placed. The project developed the New Technology Scale-Up Plan and the TB Engagement Strategy. The project's key performance monitoring indicators highlighted a general low performance observed in a number of indicators, attributed to the data collection cycle for the project that began early. In all reporting sites, data was collected starting from the 3rd of January 2018. Lesson learned by the ETB is that most facilities update source documents by the 7th of the following month after the end of a reporting quarter. Moving forward, ETB will adjust its start date of the data collection exercise from the 3rd to the 8th. Data reported and discussed in this section was collected from 130 facilities. Out of these 130 facilities, 124 were diagnostic facilities, whilst the remaining six are notification centers.