Tuberculosis-Improving access to services
Investing for Impact against Tuberculosis and HIV-Global Fund, New Funding Model
Kenya has made progress towards tuberculosis (TB) control, the latest World Health Organization (WHO) rankings reveal.
Kenya is among the 22 countries that collectively contribute to 80% of the world’s TB cases and is ranked 15 out of the 22 countries with the highest TB burden countries. Kenya’s new ranking is an improvement from its 2009 position when it was ranked 13th. In Africa, it is ranked fourth after South Africa, Nigeria and Ethiopia.
With a TB case rate of 338 people per 100,000 in 2006 to 288 people per 100,000 in 2009, in 2012 there were 120,000 new cases of TB in Kenya in 2012 and in 2014 a total of 90,000 new TB cases were reported. Kenya has improved hopes of finally getting out of the high burden countries bracket and achieving its Millennium Development Goal (MDG) TB target by 2015.
However, there is still much work to be done as it is estimated that nearly 32 people die of tuberculosis in Kenya every day. All these deaths are preventable, curable and treatable.
Globally, the WHO estimates that 9.2 million people were diagnosed with TB in 2010. In the same year, 1.1 million people without HIV died from the disease and 0.35 million people living with HIV also died.
The high occurrence of TB disease in Kenya is strongly linked to HIV infection. A HIV positive person is more likely to contract TB as a result of their weakened immune system. TB is also closely linked to poverty as it is the economically and socially disadvantaged groups that stand a higher chance of contracting the disease. The disease affects the most economically productive age group of between 15- 54, which further strengthens the close link between TB and poverty.
In this regard, KANCO is currently implementing two TB projects aimed at improving access to services:
Investing for Impact against Tuberculosis and HIV-Global Fund-New Funding Model
The project will engage the Community health volunteers (CHV) in carrying out activities that will target the community. The main activities include contact tracing of smear positive cases, contact tracing of under 5 years, defaulter tracing. The CHVs are able able to track and return the clients back to treatment. KANCO offers support in terms of logistics for the meetings and also trainings. The CSOs are mapped and there capacity built based on the needs identified during the capacity assessment and knowledge assessment.
The project is being implemented in 6 Counties and sub counties namely:-
- Kwale(Kinango, Matuga, Lunga Lunga, Msambweni)
- Bungoma (Bumula, Bungoma Central, Bungoma East, Bungoma North, Bungoma South, Bungoma West, Cheptais, Kimilili Bungoma, Mt. Elgon)
- Kitui (Kitui Central, Kitui East, Kitui Rural, Kitui South, Kitui West, Kyuso, Mwingi, Mwingi West)
- Lamu County ( Lamu East and Lamu West)
- Makueni County (Kaiti,Kibwezi East,Kibwezi West,Kilome,Makueni,Mbooni)
- Turkana County(Loima,Turkana Central,Turkana East,Turkana North,Turkana South,Turkana West)
Community Systems Strengthening (CSS) CSO component is being implemented as a pilot in Kwale County where the aim is to improve institutional capacity through Organisational Development and System Strengthening. There is also the use of I-Monitor application which is an innovative solution tool that leverages technology to enable monitoring, recording and reporting the state of services, as experienced by people themselves, thereby enabling a dialogue for transformation. The tool also aims at driving public accountability in Lunga Lunga Sub County.
To accelerate reduction of TB, Leprosy and Lung disease burden through provision of people-centred universally accessible, acceptable and affordable quality services in Kenya.
The project objectives
- Sustain the gains in the context of a newly devolved health system
- Intensify efforts to find ‘missing” cases
- Reduce transmission of TB
- Prevent active disease and morbidity
- Enhance the quality of care for chronic lung diseases
The beneficiary (s)
The following are directly and indirectly benefiting from the project:
- Community members and TB patients
- The Community Health Volunteers (CHV)
- TB stakeholders in the various counties
- CHEWs who are trained on CB DOTS
- CHVs who are trained on CB DOTS
- Prison wardens and health care workers
- CSOs i.e. FBO, CBOs, NGOs that have implemented health related activities
- Global Fund to Fight AIDS, TB and Malaria NFM through AMREF health Africa in Kenya as the Principal Recipient
Project Implementation period
October 1st 2015 – December, 31st 2017
The project aims to reach 5000 people with different interventions.
1,719 Contact tracing
- 457 Tracing of under 5
- 366 Treatment Interrupters tracing,
- 20 Sensitization of sub county data,
- 876 Support for facility teams to supervise the CHVs
- Sub county data review meetings
- Feedback meetings to the TB stakeholders in the various counties
- 244 CHEWs trained on CB DOTS
- 289 CHVs trained on CB DOTS
- 93 participants trained on ODSS
Tuberculosis Accelerated Response and Care (ARC) Project
KANCO is a linking organisation for the International HIV and AIDS Alliance (IHAA) in Kenya and as a result supports joint action on HIV & AIDS and TB at the community level and commits to developing mechanisms to help CSOs work together to achieve the shared goals.
Through the TB Accelerated Response and Care (TB ARC) project, KANCO aims to increase its efforts to fight TB in the community through engaging informal service providers so as to promote TB screening and referral.
The Project mainly target Informal Service Providers (ISPs). The project is being implemented in Nairobi, Kisumu, Homabay, Tharaka Nithi and Marsabit counties.
The overall goal is to scale up both number and diversity of private sector actors engaged in quality TB control in Kenya.
The program will focus on the following three objectives:
- To identify and categorize Informal Providers
- To streamline TB Engagement among Informal Providers and
- Scale Up of Innovative Models on Informal Service Providers
- Community Members and TB patients
- Informal providers
- TB stakeholders on the various counties
- Community Health Extension Workers and Community Health Volunteers
- County entry meetings conducted in all the 5 counties
- 383 ISPs mapped in the 5 counties
- ISP orientation package developed
- 110 participants reached in the meeting between informal health providers and formal
- 243 clients screened when they visited the ISP
- 153 clients Screened and referred to the facility
- 116 clients reached the facility that they were referred
- 23 clients confirmed to have TB and have started treatment