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Involvement of community-based organizations in the fight
against Tuberculosis and TB/VIH co-infection in Burkina
Faso
Dr Fodé [email protected]
Cancun 2009
Contents
Introduction
I. History of the project implementation
II. The community response strategyIII. Program StructureIV. Challenges and Perspective
Conclusion
INTRODUCTION 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
What is PAMAC?
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.
What is PAMAC?
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.
I. History 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;
I. History 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
II. Key point of the community response strategy (1)
A response-design with a participative approach
Taking into account health professionnals, community actors
Strategy baseline
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
Key principles
Model of CBO involvement designed around following key interventions:
- sensitization - community support services - a referral of TB symtomatics to the
health centerComplementarity and synergy between
community and health institutions with actions at national and regional levels
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)
NTP
III- Programme structure
The actors 11 Regional coordinating
networks: «structures pivot»- Role:
- coordination, - technical support, - financial support
III- Program 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
Community sensitization activity using flip chart
III- Program 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)
Psychological support to a patient
III- Program structure
Traditional healers' Associations Suspected case referral to the health
centers. Patients Associations advocacy activities in the community. PLWHA AssociationsIn charge of controling the HIV-Tb co-
infection.
Results 1
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)
Results 2
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
Challenges and perspectives 1
The sustainability of community mobilization with adequate financial resources;
Satisfying structure of CBO involvement, but varying level of expertise in CBOs;
Challenges and perspectives 2
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)
Challenges and perspectives 3
Global Fund Round 8 TB: - Starting probably in January 2010 - PAMAC is becoming PR new
challenges.
CONCLUSION 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).