Advancing TB Detection and Care through Staff Training and Mentorship in South Wollo, Ethiopia

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.

“I had only had eight months of experience in a clinical setting before I was assigned to Fito Health Center. When I began at Fito, I had difficulty handling TB patients and was unable to consult senior staff for guidance [because they lacked the skills themselves]. I also was not familiar with the TB Unit’s reporting procedures,” said Sleshi.

Fortunately, in December 2011, Fito Health Center began receiving mentorship support from the PEPFAR-funded USAID project, Help Ethiopia Address Low TB Performance (HEAL TB), led by Management Sciences for Health (MSH). HEAL TB improves the capacity of health workers to properly diagnose TB and accurately prescribe treatment regimens. The project currently supports 691 health facilities in Amhara and Oromia.

Sileshi is among the 85 TB focal persons in South Wollo Zone who were trained by HEAL TB mentors on comprehensive care for TB patients and patients co-infected by TB and HIV. Before HEAL TB’s intervention, the staff at Fito Health Center did not maintain adequate or complete reports. In addition, the health care staff rarely screened outpatients for TB, did not trace or register patients suspected of having TB, and rarely followed up on those who did test positive.

Today, after just nine months of support from HEAL TB, screening of outpatients has skyrocketed from a baseline of just 2 percent to 92 percent, and Fito staff are conducting regular and thorough follow up with all TB patients. Furthermore, HEAL TB provided the health center with tracking forms that are used to contact an infected patient’s household members so they can be offered TB screening services. HEAL TB also established a separate waiting room and treatment area for TB patients, which is adequately ventilated to prevent TB transmission among patients, visitors, and staff.

Sileshi is pleased that HEAL TB’s trainings, mentorship, and operations support have enhanced his ability to care for TB patients. “I have made significant improvements in properly recording and documenting TB cases according to the national guidelines. HEAL TB’s mentorship program has enabled me to strictly adhere to TB care standards,” he said.