With support from USAID through the Tuberculosis Accelerated Response and Care (TB ARC) activity, CHS supported a meeting that brought together County and Sub County TB coordinators to share experiences and learn from each other in efforts to end TB. The activity took place at the Pride Inn Paradise Resort, Mombasa from Tuesday, April 3,2018- Friday, April 6,2018 Partners present at the four-day meeting included the National Tuberculosis, Leprosy and Lung Disease – Program (NTLD-Program), Kenya Medical Supplies Authority (KEMSA), Kenya School of Government, Amref Health Africa in Kenya, EGPAF and AMPATH. The meeting was themed: ‘Strengthening TB control in devolved health system in Kenya‘
In his opening remarks, Director of Medical Services Dr Jackson Kioko spoke of the need to strengthen efforts in active case finding, the role community engagement has to play in ending TB, Universal Health Coverage (UHC) and the need to leverage existing structures to end TB in Kenya.
Active Case finding is a must-do for all health facilities. Kenya ought to identify 169,000 people with TB every year. Only 85, 188 were identified in 2017, a 12% increase from 2016. Many cases are still being missed. The undetected and untreated TB cases continue to fuel the spread of the disease.
Dr Jackson Kioko informed the TB coordinators that the Ministry of Health will support decentralization of TB ECHO to County and Sub-County levels. TB ECHO is a collaborative model of medical education and care management that provides health care workers with knowledge and skills to manage TB patients and more so among children. TB coordinators are key users of the TB ECHO platform and the decentralisation will go a long way in supporting them to better manage complex cases.
In line with the 2018 World TB Day theme, participants were called upon to Be leaders for TB free generation, that can only be achieved through leaders who champion efforts to end TB from the local to national level.
At the meeting, the NTLD-Program shared highlights of findings from recently concluded surveys that will be useful in informing strategies to end TB at county and sub-county levels. The surveys included one that sought to identify factors associated with non-adherence to TB treatment. The survey found that found that 35% of TB patients were non-adherent.
A survey to determine the contribution of community health volunteers (CHVs) in referral of TB patients in Kenya found that that 18% of the participants were referred to health facilities by CHVs and 67% of them were issued with a referral form. The survey further indicated that there is poor documentation of CHV referrals; patients reporting directly to the TB clinic being those most likely to be reported as referrals compared to other service delivery points.
A selection of TB coordinators from counties that had implemented facility-based active case finding shared best practices and lessons learnt from the activity aimed at finding the missing TB cases.
Through the TB ARC activity, the 47 counties and the subsequent Sub- Counties have been supplied with tablets loaded with monthly bundles and airtime to access the TIBU system. This has enabled them to collect data and monitor the TB indicators and real time reporting of the same to the NTLD- Program. A total of 500 coordinators and partners attended the end TB engagement forum.
