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USAID Tuberculosis South Africa Project USAID Tuberculosis South Africa Project Contract Number: AID-OAA-I-14-00035 Order Number: AID-674-TO-16-00002 Project Quarterly Report January 2020 to March 2020 Submitted April 30, 2020 Submitted by: University Research Co., LLC (URC) To: USAID Southern Africa USAID Tuberculosis South Africa Project - Project Quarterly Report: January 2020 to March 2020 i USAID Tuberculosis South Africa Project Contract information: This project is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of its Contract Agreement Number: Contract Number: AID-OAA-I-14-00035; Order Number: AID-674- TO-16-00002 (USAID Tuberculosis South Africa Project held by prime recipient University Research Company, LLC. and implemented by sub-recipients BEA Enterprises, Brigham and Women’s Hospital/Harvard/Partners in Health (BWH/PIH), Centre for Communications Impact (CCI) formerly JHHESA, NEXT, World Health Organization (WHO), and University of Pretoria. The USAID TB South Africa Project is funded and managed by the USAID Southern Africa mission. Prepared by: University Research Co., LLC Submitted by: Dr Gregory Jagwer Chief of Party USAID Tuberculosis South Africa Project Tel: +27 12 484 9300 Email: [email protected] Web: https://tbsouthafrica.org.za Submitted to: Ms Cindy Dlamini Project Development Specialist-TB USAID Southern Africa, Health Office Tel: +27 12 452 2330 Email: [email protected] Web: http://www.usaid.gov/southern-africa-regional For more information: Dr Refiloe Matji Vice President University Research Co., LLC USAID Tuberculosis South Africa Project Tel: +27 -12-342-1419 Email: [email protected] Web: www.urc-chs.com USAID Tuberculosis South Africa Project - Project Quarterly Report: January 2020 to March 2020 ii CONTENTS Acronyms...................................................................................................................... iv List of Tables ................................................................................................................ vi List of Figures .............................................................................................................. vii INTRODUCTION ........................................................................................................ 1 ACCOMPLISHMENTS BY INTERMEDIATE RESULTS (IRs) ................................. 2 IR 1: TB Infections Reduced ........................................................................................ 2 IR 1.1: Increased public awareness of the TB epidemic .......................................................... 2 IR 1.2: Effective implementation of Infection Prevention and Control (IPC) ..................... 8 IR 1.3: Expand strategies to reach, screen and evaluate individuals with high TB risk... 14 IR 2: Sustainability of Effective TB Response Systems Increased ......................... 16 IR 2.1: Strengthened management capacity at all levels ........................................................ 16 IR 2.2: Strengthened service delivery capacity at all levels ................................................... 22 IR 2.3: Improved data reporting and recording at all levels ................................................. 27 IR 3: Care and Treatment of Vulnerable Populations improved .......................... 35 IR 3.1: Increased contact tracing of key populations ............................................................. 37 IR 3.2: Improved TB case management among key populations ......................................... 40 IR 3.3: Strengthened comprehensive systems and partnerships for care.......................... 43 FINANCIAL MANAGEMENT .................................................................................. 48 Annexures .................................................................................................................... 49 Annex I: 90 90 90 Cascade Performance ................................................................................. 49 Annex III: Finding Missing TB Patients ....................................................................................... 65 USAID Tuberculosis South Africa Project - Project Quarterly Report: January 2020 to March 2020 iii Acronyms ACSM Advocacy, Communication and Social Mobilization AFB Acid Fast Bacilli AIDS Acquired Immune Deficiency Syndrome ART Antiretroviral Therapy BC Bacteriological Coverage CHW Community Health Worker CO2 Carbon Dioxide CPT Cotrimoxazole Preventative Therapy CQI Continuous Quality Improvement DM Diabetes Mellitus DOT Directly Observed Treatment DOTS Directly Observed Treatment, Short Course DR-TB Drug-Resistant Tuberculosis DSPs District Support Partners DS-TB Drug-Susceptible Tuberculosis DVE Data Verification Exercise ETR Electronic Tuberculosis Register FAST Finding TB Actively, Separating safely, Treating effectively PY03 Financial PY03 GXP GeneXpert® MTB/RIF (Xpert) HCT HIV Counseling and Testing HIV Human Immunodeficiency Virus ICSM Integrated Clinical Services Management IC Infection Control IEC Information, Education and Communication IPC Infection Prevention and Control IPCC Interpersonal Communication and Counselling IPT Isoniazid Preventive Therapy LDHF Low-Dose High-Frequency M&E Monitoring and Evaluation MDR-TB Multi-Drug Resistant Tuberculosis NDOH National Department of Health NGO Non-Governmental Organization NTP National Tuberculosis Control Program USAID Tuberculosis South Africa Project - Project Quarterly Report: January 2020 to March 2020 iv PEPFAR United States President’s Emergency Plan for AIDS Relief PMDT Programmatic Management of Drug-Resistant Tuberculosis PPP Public-Private Partnership PTB Pulmonary Tuberculosis QI Quality Improvement QIP Quality Improvement Plan RTCs Regional Training Centers RR Rifampicin Resistant SCR Smear Conversion Rate SOP Standard Operating Procedure STI Sexually Transmitted Infection TAT Turnaround Time TB Tuberculosis TOT Training of Trainers URC University Research Co. LLC USAID United States Agency for International Development WBOT Ward-Based Outreach Teams WC PDC Western Cape People Development Centre WHO World Health Organization XDR-TB Extensively Drug-Resistant Tuberculosis USAID Tuberculosis South Africa Project - Project Quarterly Report: January 2020 to March 2020 v List of Tables Table 1: ACSM Inicators ............................................................................................................................................................... 2 Table 2: Numbers of healthcare workers, facilities and patients reached through interpersonal communications and councelling ..................................................................................................................................................................... 3 Table 3: Numbers of people reached through build up activities towards world TB day for the period Jan-March 2020 ......................................................................................................................................................................................... 5 Table 4: Abstracts developed for presentation at various conferences to highlight work done by the project ... 5 Table 5: Districts distribution and reach through facility-based television ...................................................................... 7 Table 6: Overall FAST Implementation for the first six months of FY4 (October 2019 – March 2020)............... 12 Table 7: LAM performance report for the first six months of FY4 (October 2019 – March 2020) ....................... 13 Table 8: Lessons Learned and Corrective Actions .............................................................................................................. 14 Table 9: NMBHD TB Care Cascade, Q4 2019 to Q1 2020 .............................................................................................. 18 Table 10: Analysis of facility gaps and recommended actions to be implemented in Nelson Mandela Bay Metro ................................................................................................................................................................................................ 18 Table 11: TB care cascade for West Coast ........................................................................................................................... 20 Table 12: Missing TB patients diagnosed by strategy ........................................................................................................... 22 Table 13: Didactic Trainings ....................................................................................................................................................... 23 Table 14: Capacity Building for Managers ............................................................................................................................... 23 Table 15: Capacity Building using Low-Dose High Frequency .......................................................................................... 24 Table 16: Outcomes of the clinical questionnaire tool ....................................................................................................... 26 Table 17: Number of interviews and adverse event report forms audited in 10 study sites .................................... 27 Table 18: NMBHD Data Capturer Support ........................................................................................................................... 28 Table 19: Engagement of DOH and District
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