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USAID Defeat TB Project

The USAID Defeat TB project is a five-year project (2017 – 2022) that aims to increase tuberculosis (TB) case notification, case detection and treatment outcomes through health system strengthening with the aim of ending the TB epidemic in Uganda. Defeat TB is working in collaboration with Ministry of Health - NTLP to strengthen TB Coordination structures and is committed to build capacity across all mult-sectoral levels involved in TB control to ensure effectice support and delivery of comprehensive TB services.

The project goal is to implement community programs that lead to reduced TB-related stigma, while increasing awareness of TB and develop strong community structures that demand, utilize TB Services and Complete TB Treatment in Kampala City central division. Objectives of the project are:

  1. Raise awareness on TB for stigma reduction and availability of TB treatment through 5 targeted community sensitization meetings to ensure timely TB diagnosis and treatment by 2019
  2. Identify and build the capacity of selected community based TB survivors to act as Community TB Champions and provide psychosocial support to ensure increased case detection and treatment success rates by 2019
  3. Establish peer support groups and build the capacity of treatment supporters through training workshops to improve adherence to TB treatment by 2019

AIDS Information Centre (AIC) is one of the CSO partners for the USAID Defeat TB project implementing Community TB control in Lubaga and central division of Kampala city and Entebbe municipality Wakiso district since July 2018. 

Based on the number of new TB cases enrolled by AIC supported health facilities daily from interventions focusing on patients active on TB treatment and mass community screening and sensitization, there needed to be an approach to leverage on the huge human capital of TB survivors. Therefore, in consideration to the complex social characteristics of the urban community defined by very high mobility, business mindedness, poverty, complacence, social fear and stigma, there required a user friendly, high impact but cost effective and highly innovative model, thus AIC pioneered the “Neighbourhood Approach

In this approach, any person near a TB survivor at anytime and anywhere is classified as ‘a neighbour’. In November 2018, 90 TB survivors were identified and trained as TB Champions. These were trained the basics of community TB control in order to effectively reach out to the vulnerable urban communities of Entebbe and Kampala city. The “TB champions” were equipped with community-facility referral registers and IEC materials. Once identified with symptoms of TB, the champion documents and refers or escorts the presumptive case to the nearest TB screening or diagnostic and treatment units (DTUs). The community linkage facilitators and the hub riders work closely with the champions and the health facilities to ensure no missed opportunity. Weekly telephone calls and the spot checks are made to the champions to get updates on the progress and data captured into the community tools.

Results

In the first 3 months of implementation of the Neighbourhood approach, 112 people were identified with symptoms for TB out of which 15 TB cases were confirmed.  All these TB cases were linked to care and treatment. This has contributed 11% of TB cases notified within 6 months of engaging this civil society organization in community interventions in urban Kampala