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Tuberculosis (TB) remains a major public health problem in the regions of East, Central, and Southern Africa (ECSA). Because TB is an airborne disease, its transmission is facilitated by the movement of people across internal and national borders.

Over six years (2011-2017), the USAID-funded Leadership, Management, and Governance (LMG) Project strengthened health systems to deliver more responsive services to more people.

The primary goal of the Challenge TB (CTB) project in Afghanistan is to assist the NTP to reach its strategic objective of increasing TB case notifications by at least 8% annually through comprehensive TB care and prevention activities.

In high TB- and HIV-burden settings, the two diseases reinforce each other and share common risk factors. Single, categorical services provided to persons with multiple, related risk factors miss opportunities to diagnose, treat, and prevent TB and/or HIV.

The Champion Community approach, which is owned and sustained at the health area level, was established by the Integrated Health Project (IHP) and IHPplus to encourage community members to decide on their health priorities and to teach them to sensitize their communities on those priority health issues.

The availability of timely, high-quality health data remains a challenge in the Democratic Republic of the Congo (DRC), despite some significant progress. DRC is a vast, landlocked country where the distances between health facilities, especially at different levels of the health system, are often great.

The DRC National Strategic Plan 2014-2020 outlines a multi-sectoral vision that aims to increase the modern contraceptive prevalence to 19% and provide access to and use of modern contraceptive methods to at least 2.1 million women by 2020.

In its National Health Development Plan 2016-2020, the Democratic Republic of the Congo (DRC) aims to reduce maternal deaths per 100,000 live births from 846 to 548 and to reduce infant and child mortality from 104 to 60 deaths per 1,000 births.

To treat infections in newborns and young infants (age 0 to 59 days), WHO recommends transferring them to a hospital and administering a regimen combining two injectable antibiotics, namely, penicillin or ampicillin, plus gentamicin for seven to ten days.

Strengthening information systems to support health data use is a critical component of quality improvement. In the past, research on quality of care has focused on the availability of resources and implementation of clinical guidelines, while often ignoring the regular metrics and monitoring systems used to inform decision making and manage improvement initiatives.

Bangladesh is one of the world’s high tuberculosis (TB) burden countries. According to World Health Organization’s 2017 Global TB Report, 38% of drug-sensitive and approximately 84% of drug-resistant patients are undiagnosed or unreported. The most infectious TB patients are these missing cases.

GxAlert is a web-based open-source data connectivity application that includes a system for data management designed to work with any diagnostic device that can connect to the internet or a mobile network.

Ethiopia is one of the most populous countries in Africa with a high TB burden across a wide geography. The national TB program has reached hundreds of thousands of cases and successfully treated them. However, health authorities believe that a third of cases have been missed in the community, development corridors, industries, and crowded settings, such as universities.

Blended learning is an approach that combines independent reading with short off-site training. Management Sciences for Health (MSH), under the guidance of the Ethiopia National TB Program and in partnership with the All-Africa Leprosy, Tuberculosis and Rehabilitation Training Center (ALERT), pioneered a blended learning approach for TB training in Ethiopia.

Despite making good progress toward digitizing client level data, the Government of Tanzania is still working to meet the latest global guidelines for HIV/AIDS programs. One major reason is that the country’s data collection and HIS do not efficiently deliver the quality information required for effective monitoring and planning.

Urban health facilities present particular challenges in TB service provision.

Mobile applications play an important role in field data collection in developing countries. However, poor infrastructure remains a challenge to fully utilizing mobile services. e-TB Manager, an electronic tuberculosis (TB) management system, is a web-based tool used to manage all TB-related data and information needed by national TB control programs.

The National TB Programme (NTP) in Ethiopia is committed to decentralizing and scaling up implementation of drug resistant TB (DR-TB) management by using an alternative ambulatory model to increase access to care. Challenge TB in collaboration with the NTP supported the implementation of programmatic management of DR-TB (PMDT) across the country by expanding treatment initiating centers (TICs

Contact investigation (CI) refers to the systematic evaluation of individuals who have been in close contact with potentially infectious TB cases within three months of TB treatment initiation. In Ethiopia, the USAID-funded HEAL TB and Challenge TB projects implemented three CI approaches: routine or prospective, reverse, and retrospective.

In Nigeria, tuberculosis (TB) is a major public health problem and low case finding remains a challenge to its eradication. The USAID-funded Challenge TB project supports GeneXpert sites across the country. However sub-optimal GeneXpert utilization due to modular failures, power supply issues, and inadequate samples has contributed to low TB case finding.

The Technical Support Services Project (TSSP) worked with the Tanzania Ministry of Health, Community Development, Gender, the Elderly, and Children (MoHCDGEC) to support and strengthen the Star Rating Assessment (SRA) Tool system. The project integrated HIV/AIDS indicators into the tool to create more comprehensive assessments of the country’s health care facilities. 

In collaboration with the USAID-funded Rwanda Health Systems Strengthening Project and partners, Rwanda’s Ministry of Health introduced the Workload Indicator of Staffing Needs (WISN) tool in all public district and provincial hospitals in the country.

The Rwanda Medical Procedure Coding (RMPC) system was developed by Rwanda’s Ministry of Health, with technical assistance from the USAID-funded Rwanda Health Systems Strengthening Project, to harmonize procedure coding with an international standard.

A key challenge identified by a study on health sector staff retention, conducted by the USAID-funded Rwanda Health Systems Strengthening Project in 2017, was the lack of access to credit at a reasonable interest rate from commercial banks for building a home, purchasing essential items or meeting emergency expenses.

In collaboration with the Ministry of Health and other health sector stakeholders, the USAID-funded Rwanda Health Systems Strengthening Project conducted many interventions aimed at improving the performance of the health system at all levels.

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