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Involvement of community-based organizations in the fight against Tuberculosis and TB/VIH co-infection in Burkina Faso. Dr Fodé SIMAGA [email protected] Cancun 2009. Contents. Introduction History of the project implementation The community response strategy Program Structure

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Involvement of community-based organizations in the fight against Tuberculosis and TB/VIH co-infection in Burkina Faso

Dr Fodé SIMAGA

[email protected]

Cancun 2009


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Contents against Tuberculosis and TB/VIH co-infection in Burkina Faso

Introduction

  • History of the project implementation

  • The community response strategy

  • Program Structure

  • Challenges and Perspective

    Conclusion


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INTRODUCTION against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • Burkina Faso Round 4 Global Fund grant implementation: NTP and PAMAC partnership

  • In terms of community/CBO mobilization, the national context made it possible to implement a country-wide CBO involvement strategy


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What is PAMAC? against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • Support Program to Community-based Organizations:

    National Programme funded by different Partners to support community-based organizations involved in the fight against HIV, Malaria and Tuberculosis.


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What is PAMAC? against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • PAMAC's role :

    - Build community-based organizations' technical and financial capacity.

    - Empower them to deliver quality services complementing the health system

    - Empower them to become recognised actors.


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I. against Tuberculosis and TB/VIH co-infection in Burkina FasoHistory of the project implementation (1)

  • Since 2005, PAMAC is chosen as SR for the community response for GF round 4 TB

    It is about:

    - implementing the community response of the National TB Programme;


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I. against Tuberculosis and TB/VIH co-infection in Burkina FasoHistory of project implementation (2)

- elaborating a community/CBO response implementation strategy respecting the demands of all actors,

- organizing and coordinating community actions,

- Build their capacity in a sustainable way


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II. Key point of the community response strategy (1) against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • A response-design with a participative approach

    Taking into account health professionnals, community actors


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Strategy baseline against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • National intervention taking into account urban and rural specificities;

  • Emphasis on vulnerable populations through patient-based and community activities;

  • Functional country-wide M&E and supervision system for CBO involvement


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Key principles against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • Model of CBO involvement designed around following key interventions:

    - sensitization

    - community support services

    - a referral of TB symtomatics to the health center

    Complementarity and synergy between community and health institutions with actions at national and regional levels


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NTP against Tuberculosis and TB/VIH co-infection in Burkina Faso

Sensitization: 11 regional networks

Treatment support: 1 regional network

CBOs (sensitization, referrals)

Traditional healers (referrals)

District

Health

Center

PLWHA org's (sensitization, referrals)

TB pts orgs (support, referrals)

Urban treatment support Org's (home visits, defaulter retreival, referrals)


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III- against Tuberculosis and TB/VIH co-infection in Burkina FasoProgramme structure

The actors

  • 11 Regional coordinating networks: «structures pivot»

  • Role:

    • coordination,

    • technical support,

    • financial support


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III- against Tuberculosis and TB/VIH co-infection in Burkina FasoProgram structure

  • CBOs involved in sensitization

  • Theatre

  • Cinema and debates

  • Community sensitization dialogues

    ! During these activities TB symptomatics will be referred to the health centers (referral sheets developed).

  • Quarterly supervision by Regional Network


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Community sensitization activity using flip chart against Tuberculosis and TB/VIH co-infection in Burkina Faso


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III- against Tuberculosis and TB/VIH co-infection in Burkina FasoProgram structure

  • CBOs involved in community support

    - permanent presence in the TB Tx/Dx centers

    - Support to patients with adherence-to-treatment-related challenges

    - home visits (with contact investigation and referral of symptomatics)


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Psychological support to a patient against Tuberculosis and TB/VIH co-infection in Burkina Faso


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III- against Tuberculosis and TB/VIH co-infection in Burkina FasoProgram structure

  • Traditional healers' Associations

    Suspected case referral to the health centers.

  • Patients Associations

    advocacy activities in the community.

  • PLWHA Associations

    In charge of controling the HIV-Tb co-infection.


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Results against Tuberculosis and TB/VIH co-infection in Burkina Faso1

  • From October 2005 to march 2009:

  • 3 597 community actors trained in Tuberculosis prevention and care

  • 28 322 prevention activities conducted in which (50% of activities supervised by health staff)


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Results 2 against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • More of 1 777 572 persons sensitized

  • 7534 Tb patients benefited from one form of treatment support activity

  • 10433 home visits realized

  • 12162 suspected cases referred from which 873 tested positive


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Challenges and perspectives 1 against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • The sustainability of community mobilization with adequate financial resources;

  • Satisfying structure of CBO involvement, but varying level of expertise in CBOs;


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Challenges and perspectives 2 against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • A real integrated approach of HIV and Tb control   TB/VIH coinfection

  • Further increase in contribution to sm+ case detection needed Principal challenge of the national strategy

    (n.b. Challenges with estimated CDR [less than 20%] – most probably a gross-understimate – prevalence survey planned in 2010)


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Challenges and perspectives 3 against Tuberculosis and TB/VIH co-infection in Burkina Faso

Global Fund Round 8 TB:

- Starting probably in January 2010

- PAMAC is becoming PR new challenges.


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CONCLUSION against Tuberculosis and TB/VIH co-infection in Burkina Faso

  • An organized and structured CBO netowork is able to respond to the challenges of fighting against Tb

  • The round 8 will ensure continuity of activities. It will build on the success and experiences of 5-year implementation and address observed weaknesses (primarily to respond to the principal NTP challenge: increasing case detection).


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Thank against Tuberculosis and TB/VIH co-infection in Burkina Fasoyou for yourattention


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