Union World Conference on Lung Health

Transcription

1 The Global Fund and Civil Society-An essential partnership: Strengthening collaboration between the NTCP and civil society through a national Stop TB Partnership in Swaziland SANDILE GININDZA NATIONAL TB PROGRAMME RESEARCH, M&E OFFICER 42nd Union World Conference on Lung Health Thursday, 27 October Lille, France

2 Swaziland: Overview & TB/HIV situation Land-locked approximately 17,000 square Kilometers With a population of 1,018,449 people (2007 Census) The country has a high HIV prevalence rate among the general adult population aged of 26%. Estimated TB incidence 1,257/100,000 (2010 WHO Report) HIV prevalence among TB patients: 83% (2010 WHO Report) MDR-TB prevalence rate : 7.7% in new cases and 33.9% in previously treated (National DR Survey, 2009) TB declared an Emergency in March 2011 Civil society mainly service delivery and advocacy oriented; Government has a history of collaboration with Civil society in health care and educational sectors through subventions since the 1980 s An existing NGO policy.

3 Types of Civil society in Swaziland Health Service delivery oriented: Faith-based organizations Corporate entities (Involved in health services for staff and host communities); Local CBO/NGOs (involved in health care and development projects mainly in rural areas); International NGOs (e.g. Red Cross, World Vision, MSF, URC etc involved in health care services) Patient support and literacy oriented SWANNEPHA: Support group to provide adherence and psychosocial support to patients; Women groups (e.g. Women Together, Mothers to Mothers etc) FBOs/CBO/NGOs ACSM oriented Journalists Swaziland Council of Churches SWAPOL SWAGAA Save the Children Women and Law etc

4 Motivation for collaboration with CS Programmatic challenges Inadequate capacity in the NTCP including HR: 4 staff members at NTCP in 2006 doing mainly clinical work Inadequate technical guidelines to guide implementation Poor TB outcomes (in 2006, CDR 49% ; TSR 42%); Inadequate drug supply system; Inadequate coordination of stakeholders who are working in various locations; Inadequate awareness about TB Inadequate programme funding Inadequate capacity to plan and budget

5 Steps to collaboration with CSOs National TB Programme Review 2007 Review team recommendations highlighting the potential in CSOs and the need for collaboration; Formation of the Technical Working group (TWG) to coordinate technical aspects; Stakeholders meetings on partnering with CSOs Partners Resource mapping to determine areas of comparative advantage; Development of Global Fund proposals Round 8 and 10 (reflect Partners activities) Development of partnership framework Validation by Legal department of MOH; TA of WHO and Stop TB Partnership; Undertook a KAP survey with involvement of partners Launch of the Stop TB Partnership Constitution of the Partnership Board

6 Results of the Collaboration Programme Improved TB outcomes (CDR increased from 49% in 2006 to 78% in 2009, Annual National TB Report, 2009; TSR increased from 42% in 2006 to 68% in 2009, WHO Report 2010) Improved partner coordination Increased uptake of TB/HIV interventions (HTC Uptake increased from 13% in 2007 to 86% in 2010, National Annual TB Report,2010) Increased Community involvement in TB care (patient support: 12 CSOs collaborating in providing treatment to over 1000 TB patients already through community treatment supporters) Improved programme M&E (improved reporting by all stakeholders in TB Control) Declaration of TB as an emergency (CSOs advocated for TB to be declared an emergency and was declared in March 2010) Improved adherence to national guidelines CSO partners Increased collaboration among partners; Improved use of resources through avoidance of duplication; increased resources through the GF

7 Results of the Collaboration: Improved use of resources through avoidance of duplication Sample Transportation system cars supported through URC Comprehensive TB/HIV clinic in Matsapha supported by MSF MDR-TB Ward at Nhlangano HC supported by MSF TB clinic at RFM supported by URC

8 Challenges Limited capacity in terms of TB expertise, HR etc especially among the CBOs and some FBOs; Lack of mechanism for supporting work of partners in the field especially at the community level; Difficulty in the logistics of patient support at the inception of the project; Limited financial resources

9 Future plan Continue strengthening the Swaziland Stop TB Partnership; Establish system of support for partner activities in the field through supervision by the Stop TB Partnership; Strengthen capacity of CBO/NGO/FBO partners Greater involvement of partners in programme planning and review; Mobilization of additional resources.

10 ACKNOWLEDGEMENT SWAZILAND URC STOP TB PARTNERSHIP Ministry of Health The Global Fund To Fight AIDS, Tuberculosis and Malaria (GFATM) World Health Organization (WHO) University Research Coo. (URC) Médicens San Frontiers (MSF) National Emergency Response Council on HIV and AIDS (NERCHA) Swaziland STOP-TB Partnership Government of Swaziland-Ministry of Health (MOH)