ACSM TA KENYAS Experience

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ACSM TA KENYAS Experience

• By
• Jane Nyangara Onteri
• Programme officer
• Division of Leprosy, TB and Lung disease
• ACSM at country level sub-group Working Group
  Meeting
• At
• Southern Sun Hotel- Cape Town
• 5th -6th November 2007

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Kenya
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Background

• Republic of Kenya covers an area 582,646 sq kms
• About 80 of its land is arid or semi-arid and is
  sparsely populated
• Population was projected to be 33, 829, 590 (est.
  2005)
• Life expectancy had dropped from 56.8 years in
  1992 to 51 years in 2004 due to the AIDS epidemic
• GDP (2006 est.) 22.79 billion
• Annual economic growth rate (2006) 6.1
• Gross national income per capita (2006) 455

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Background cont.

• Kenya is ranked 10th among the worlds 22
  countries with a high TB burden.
• Kenyas TB burden and rates have increased
  dramatically a more than tenfold increase from
  10,000 in 1987 to 115,234 in 2006.
• Case notification rate increased from 110 per
  100,000 population in 1987 to 325 per 100,000 in
  2006

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Background cont.

• TB treatment success rate stands at about 81 as
  of 2005
• TB case detection rate of sputum smear positive
  cases (SS) has remained low, at about 45 (WHO,
  2007)

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ACSM TASK Force.

• Formed in 2005
• Terms of reference are
• To develop strategies for the implementation of
  ACSM activities
• To promote multi-stakeholder involvement in the
  implementation of ACSM activities

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ACSM Task Force TORs Cont.

• To develop suitable health care worker training
  programs, training manuals/guides and other
  materials to promote best practices in the
  implementation of ACSM activities
• To develop suitable indicators for monitoring and
  evaluation of ACSM activities
• To hold quarterly ACSM review meetings

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The ACSM TASK Force Cont--

• TASK Force Membership
• DLTLD-Focal persons for ACSM (MOH)
• DLTLD-Focal person for CB-DOTS (MOH)
• PATH (Partner)
• FHI (Partner)
• AMREF (Partner)
• NASCOP (MOH)
• PSI (Partner)
• NEPHAK (Partner)
• Division of Environmental Health (MOH)
• Division of Health promotion (MOH)

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TA for ACSM

• For formation of Task force
• Development of R5 GFATM
• Development of advocacy and communication
  strategy documents
• Development of overall TB strategic plan
  2006-2010.
• Development of TB ME framework

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Tools developed for ACSM

• National TB/HIV Communication strategy was
  developed and launched (Lights of Hope)
• DLTLD National strategic plan -2006 to 2010
  developed (issues on ACSM addressed)
• Monitoring and Evaluation framework for DLTLD has
  been developed (ACSM Addressed)
• Development of the National Advocacy Strategy to
  Fight TB/HIV is in progress (draft is available)
• TB community sensitization guide for community,
  business and religious leaders (Draft available)
  

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National Communication strategy

• The communication strategy was developed and
  launched March 2007 (Lights of Hope)
• It addresses issues of symptoms, diagnosis and
  treatment and communication channels

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National Advocacy strategy

• National Strategy to Fight TB/HIV draft is
  available
• It address issues of policy,
• stakeholders/development partners,
• TB/HIV collaboration
• human resource and logistics

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Funding

• ACSM is funded by GFATM round 5
• The main objectives in the Round five proposal
  were
• To advocate for development of supportive
  policies and increased funding for TB programs
• To increase awareness and knowledge on TB and
  reduce its associated stigma in the general
  public and people with TB/HIV

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Funding cont.

• To mobilise the community and build its capacity
  to respond to the TB epidemic
• To monitor and evaluate ACSM Activities
• Apart from Global fund and GOK, the program also
  receive funds from CDC and WHO for ACSM
  activities

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ACSM Achievements

• Advocacy
• TB/HIV advocacy strategy draft is in progress
• A task force on ACSM formed, functioning and
  meets on quarterly basis
• Communication
• TB/HIV communication strategy has been developed
  and disseminated
• Mass media campaign on going
• Magnet theatre trainings going on Over 600
  persons trained on TB/HIV
• Quarterly newspaper advertisement done and on
  going
• Production of IEC materials- Posters, Brochures,
  T-shirts, pamphlets, leaflets, flyers, stickers,
  spin wheels

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Achievements cont.

• Social Mobilization
• Public health Officers sensitized on ACSM- 73 /80
  districts(91.25)
• Civic and religious leaders sensitized in 32/80
  districts(40)
• Training and retaining of TB ambassadors on going
  
• Peer to peer education at workplace on going-
  about 599 persons from different companies
  trained on TB/HIV
• Survey on private DOTs providers offering low
  cost TB services and those willing to do so on
  going

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Specific Activities 1.Mass Media campaign 2007

• TV - Citizen, KTN, NTV between 8pm - 9pm
• Makutano Junction a TV 30 minutes program
  supported by CDC on going.
• Radio spots- Citizen, Easy, Ramogi, Inooro,
  Kameme, Simba and Mulembe. Time between 6am -
  9am and 4pm - 7pm
• Radio 30 minutes call in show 12 shows done
  with 12 TB/HIV topics
• Print Nation, Taifa leo and Standard Newspapers

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Mass media campaign cont.
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New paper adverts
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Newspaper adverts cont.
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Newspaper advert
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2. IEC Materials produced
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3. T-shirts
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Monitoring and Evaluation

• Campaign placement is being monitored through
  Steadmans media monitoring service, to ensure
  that commercials are aired correctly and
  according to schedule
• Support supervision is being offered to the
  districts and the provinces on ACSM
• A survey will be carried out on the impact of
  ASCM activities soon

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Challenges

• How to increase case detection and treatment
  success rates
• Reduction of defaulter rates and out of controls
• Prevention of emerging MDR-TB
• How to motivate and increase staff morale
• How to integrate TB services with other public
  health services
• How to build a cohesive provincial and District
  teams
• How to reduce TB/HIV stigma
• Human resource issues such as shortages and
  training

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Conclusion

• TB progam in Kenya is well managed, working and
  with continued support that we are currently
  receiving, we envisage significant reduction of
  TB cases and hope to reverse the trends

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Let us join hands together and fight TBTHANKS