SPF Project



COMMUNITY BASED TB TREATMENT SUPPORT

Funded by: URC (TBSA)

Project Coordinator: Dr Paul Cromhout

Sector: Health

This project in Nyandeni, a sub district of OR Tambo District, is a 12 month project that started in October 2017.

The project is operating in 5 clinic/sites in Nyandeni focusing on drug susceptible TB (DSTB, TB that can be treated with first line treatment).

As is the hall mark of SPF the strategy is a community based approach towards the prevention, treatment and care of TB.

Objectives:

Ø  To train the staff on TB management by September 2018.

Ø  To intensify case detection in Nyandeni Sub-district by October 2018.

Ø  To intensify DOT support in Nyandeni Sub-district by October 2018.

Ø  To increase TB/HIV integration in Nyandeni by October 2018.

Ø  Intensify DSTB contact management in Nyandeni by October 2018.     

Ø  To conduct Advocacy, Communication and Social Mobilization activities (ACSM) in Nyandeni by October 2018.

 

SPF are in discussions with TBSA in terms of the possibility of applying for additional sites, post October 2018, when the current project ends, in terms of DSTB and or Drug Resistant TB (DRTB).

The districts with the highest TB burden in the Eastern Cape are Nelson Mandela Bay, Buffalo City and OR Tambo in terms of disease prevalence.

SPF have expressed an interest in supporting the ECDOH in both Buffalo City and OR Tambo Districts in the TB strategy going forward.

 

Challenges:

·         We were unable to meet project targets for the first two months of the project due to the too ambitious start up targets, use of project staff by clinics for non-project related work and the vast rural nature of the site certainly added to initial challenges.

·         Ongoing taxi violence in the MTHATHA, Libode Port St Johns route affected mobility of our clinical coordinator resulting in the project having to fetch her and again drop her off daily adding to an additional 80km daily at considerable time and cost to the project.

·         The rural nature of the project and the fact that the furthest Pilani clinic/site is 100 km from the office and takes 2-3 hours to travel due to the topography.

·         The shortage of sputum jars at the clinics supported by the project.

·         The initial high turnover of community health workers.

·         The use of project contracted CHW’s by some of the clinic staff at some of the clinics/sites, resulting in CHW’s undertaking completely unrelated activities in the clinics such as taking of blood pressure (BP), rather than being out in the community treating TB.

·         This use of staff by clinics initially was at the expense of target deliverables and resulted in targets not being met within the first two months of the project.

Successes:

·         The project managed to maneuver around the taxi violence which persisted for 4 months, no project days were lost as a result of the disruption of public transport.

·         The project initiated a weekly on site review/support/mentor strategy at all 5 sites for all 21 contracted CHW’s, this has proved very valuable and beneficial to the project.

·         Co-funding in terms of the CWP has assisted to bridge the gap in terms of the high transport cost brought about by the taxi violence and the geographical nature of the terrain.

·         The project coordinator has managed to address the shortage of sputum jars at the clinics/sites with his connection and inter personal skills with the National Health Laboratory Service (NHLS).

·         The initial high turnover of CHW’s slowed down when they realized that they were being empowered and given life skills as well as the stipend.

·         The use of some CHW’s by some of the clinics was addressed in month two of the project.

·         Project targets are being exceeded continuously from month three of the project.

·         TB patients are being cured and contacts are being traced, screened and helped to remain TB free.

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