Tuberculosis: Our Impact

In Uganda, management of tuberculosis (TB) medicines is fully decentralized. Like other government and private programs, the Ministry of Health’s (MoH) National Tuberculosis and Leprosy Program (NTLP) procured and supplied tuberculosis (TB) medicines independently to district stores.

Dr. Anyo takes staff and interns through a hands-on training exercise during onsite supervision. {Photo credit: Gladys Anyo/MSH.}Photo credit: Gladys Anyo/MSH.

While tuberculosis (TB) is receiving widespread attention in the global health community, many in South Sudan still consider this disease a repulsive affliction and feel uncomfortable associating with TB patients. In addition to fear and discrimination in the general population, the nation’s health professionals often avoid working with TB patients, TB equipment, and sputum samples for fear that they could become infected themselves.

Dr. Eliud Wandwalo. {Photo credit: MSH.}Photo credit: MSH.

MSH works with international, national, and local partners to strengthen the capacity of health systems, national tuberculosis (TB) programs, and health managers to improve the lives of those affected by TB and prevent the spread of the disease. MSH participates in several global TB initiatives, including USAID’s Tuberculosis CARE I Program (following the TB CAP program); the STOP TB Partnership; and the Global Fund to Fight AIDS, Tuberculosis, and Malaria.

Sileshi Idris recording TB data at Fito Health Center, Ethiopia. {Photo credit: Kelem Kebede/MSH.}Photo credit: Kelem Kebede/MSH.

“I once had tuberculosis myself. I was stigmatized by the community and could not receive appropriate treatment. My own suffering encouraged me to serve the community so I could protect more people from being infected by TB,” said Sileshi Idiris, a clinical nurse and tuberculosis (TB) focal person at Fito Health Center in Ethiopia. Despite his enthusiasm to work as a TB focal person, Sleshi initially lacked the knowledge and skills to properly care for TB patients. Sleshi needed clinical skills training and guidance on how to follow Ethiopia’s national TB control guidelines.

Staff from a medical team at Gerems Health Center who were trained by HEAL TB to identify individuals with TB symptoms and refer them to a health center for treatment. {Photo credit: Dr. Kassahun Melkieneh/ MSH.}Photo credit: Dr. Kassahun Melkieneh/ MSH.

Twenty-two-year-old Melkamu Belete was misdiagnosed and left without proper treatment for six months. Although Melkamu had visited four health facilities to be treated for a cough, fever, and loss of appetite, the health care staff did not test him for tuberculosis (TB). Instead, each facility sent him home with antibiotics that did not heal him. Despite worsening symptoms, Melkamu eventually gave up and stopped seeking medical advice.

The USAID-funded TB CARE I project, led by KNCV Tuberculosis Foundation (KNCV) in partnership with Management Sciences for Health (MSH), is conducting a pilot study in 28 health facilities in Ethiopia to roll out standard operating procedures (SOPs) for improved tuberculosis (TB) diagnosis, treatment, and care.The SOPs include instructions for TB screening, irrespective of the patient’s presenting illness or chief complaint.

Nurse Mpala Muhungu in Lubudi, with two children diagnosed with TB following the DRC-IHP training. {Photo credit: MSH.}Photo credit: MSH.

Nearly one in two cases of active tuberculosis (TB) went undetected in the Democratic Republic of Congo in 2010, due to inadequate screening for the disease.

Despite progress made to reduce tuberculosis globally, it still remains one of the primary infectious causes of morbidity and mortality worldwide. Drug resistance to the disease has not only grown, but it has also impacted those co-infected with HIV/AIDS. With an increase in awareness by the global community and rising political will, countries are seeing a growth in funding to fight TB through various global initiatives.

The Grant Management Solutions Project (GMS) invites you to participate in the GMS End of Project Conference! We will highlight five years of results and lessons learned from technical support to grantees of the Global Fund to Fight AIDS, Tuberculosis, and Malaria in 78 countries.This event will be held Friday, June 29, 2012, at the National Press Club in Washington, D.C. from 9:00am to 5:00pm.Presenters will include representatives of the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the U.S. Agency for International Development; and the Office of the U.S.

Elizabeth Oywer, the registrar of the Nursing Council of Kenya (center), is recognized for completing the Leading High Performing Healthcare Organizations by Dr. Edward Mungai, dean of the Strathmore School of Business in Nairobi, and Joan Mansour, leadership development specialist at Management Sciences for Health. {Photo credit: MSH.}Photo credit: MSH.

Four years ago, a national assessment done by the Ministry of Health in Kenya showed that 61% of health managers felt inadequately prepared for their roles due to lack of skills in leadership and health systems management. The assessment report recommended that these gaps be addressed at the pre-service and in-service training levels for health workers and also at the senior management level of the health sector.

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