Project Fact Sheet | South Africa

Who we are

The USAID-funded Tuberculosis Project South Africa (2009–2014), implemented by University Research Co.,

LLC (URC), builds on the successes of the USAID-funded TASC II TB Project (2004–2009). The project works closely with the South African National Department of Health and other stakeholders to support the government’s health sector reform through the expansion of quality and accessible TB services. In addition, the project works with provincial and district health departments in the development, implementation, and evaluation of needs-based strategies to combat TB, TB/HIV, and drug-resistant TB and to promote best infection control practices. This support is also helping communities create appropriate advocacy, social mobilization, and health systems strengthening and innovate service delivery models for the rapid expansion of Directly Observed Treatment Short course (DOTS) for the control of TB.

Focus areasIncrease the quality of TB services¡ Work with National Department of Health, provinces,

districts, and other stakeholders to develop and implement strategic interventions that address the threats of TB, TB/HIV, and drug resistant TB

¡ Jointly review and update clinical and programmatic guidelines for TB, TB/HIV, and drug-resistant TB

¡ Review laboratory systems at all levels of intervention, by conducting needs assessments, mapping TB microscopy diagnostic centers countrywide, and addressing laboratory challenges

¡ Strengthen the six components of the expanded STOP TB strategy

¡ Conduct operational research on programmatic aspects of the project jointly with institutional partners

The USAID Tuberculosis Project2009-2014

April 2011

Joyce Ramakau conducts health talk and TB screening to police officers in Free State Province

Increase the availability of TB services¡ Provide need-based trainings for health care staff at all

levels of the system on basic TB management; TB/HIV, including the national 5I’s (international 3I’s + integration and initiation of antiretroviral therapy, or ART) and prompt provision of antiretrovirals for co-infected patients; programmatic and clinical management of drug-resistant (DR) TB; laboratory diagnosis of TB and DR TB; and advocacy, communication, and social mobilization (ACSM)

¡ Provide and facilitate implementation of TB/HIV health care services from provincial to facility levels as per WHO recommendations and through innovative models

¡ Assist provinces and districts in implementing the national strategy for decentralization of DR TB management

Increase the demand for TB treatment¡ Promote and participate in the implementation of the national

ACSM policy through national events (i.e., World AIDS and TB days, TV and radio public service announcements), local activities (e.g., community dialogues, Kick TB campaign), and distribution of materials (e.g., pamphlets, posters, lap desks with TB messages for school children)

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¡ Disburse grants to and build the capacity of nongovernmental and community/faith-based organizations to expand community-based TB, TB/HIV, and multi-drug-resistant (MDR)/extreme drug-resistant (XDR) TB management

Improve management of TB support systems¡ Improve TB program management at all levels of

intervention through data verification exercises and ongoing interaction with relevant counterparts

¡ Jointly analyze reports and link them to facility case management

¡ Strengthen facility-based TB information systems through regular data quality audits

¡ Improve supportive supervision and surveillance¡ Strengthen linkages between health facilities and

laboratory networks

Test and scale up new approaches for expanding DOTS coverage¡ Support the expansion of rapid molecular testing methods

(mainly XPert MTB/Rif®) as provided in the national strategy

¡ Identify and support TB and TB/HIV public-private mix strategies and interventions

¡ Disseminate the use of geographic information system (GIS) technologies to map laboratories, health facilities, treatment supporters and households for better TB control including DR TB

Key achievementsTraining ¡ Trained 20,308 health care workers (7546 with USAID funds

and 12,762 with funds from the President’s Emergency Fund for AIDS Relief [PEPFAR])

¡ Conducted national training to finalize the new package of training materials on the NTCP guidelines; followed up with roll-out trainings on the revised and new sections of the guidelines, including the GeneXpert algorithms, with 389 participants

TB/HIV ¡ Increased TB screening among HIV-positive clients in the

project’s TB/HIV facilities from 74.5% in Q1 2010 to 96.3% in Q4 2011

¡ Increased HIV counseling and testing uptake in TB patients from 75.9% in Q1 2010 to 92% in Q4 2011

¡ Improved (1) IPT uptake among HIV-infected patients through improved recording calling for follow-up with patients on intermittent preventive therapy (from 5535 in Q1 2010 to 10,634 in Q4 2011) and (2) CPT uptake among TB/HIV co-infected patients from 70% in Q1 2010 to 92% in Q4 2011

These improvements are attributed to consistent supportive supervision and in-service training and mentoring offered to facility staff by provincial coordinators.

Public-Private Mix (PPM) ¡ Expanding private sector participation in TB service

delivery by leading a National Public Private Mix Summit; developing an implementation strategy for PPM; and starting PPM activities in several provinces with employers, private practitioners, and traditional healers

Dr. Limenako Matsoso and Aziz Shabodien of the USAID TB Project with other walkers during the TB Walk for Humanity procession from SABC studios to Park Station in central Johannesburg

TB screening being conducted in North West Province by Provincial Coordinator Georgina Wessie

The USAID Tuberculosis Project • 3

ACSM ¡ Reached 72% of South Africans residents ages 16–64 and 62%

of children ages 5–14 through Stop TB TV commercials

¡ Reached over 40,000 school-aged children through the “Kick TB” campaign, which– fuses soccer and social mobilization to create a platform through which TB-appropriate messages are conveyed to youth

¡ Designed, developed, and produced 48,000 posters in seven languages; the posters address TB/HIV, infection control, treatment adherence, and ventilation.

¡ Trained over 200 people from TB directorates in three provinces

¡ Conducted six community dialogues in rural and informal settlements across four provinces in South Africa, engaging more than 500 community members and sparking their interest in addressing TB and TB/HIV challenges

Community MDR TB Management ¡ Conducted workshops in four provinces on the implementation

of community management of drug-resistant TB

Small Grants ¡ Awarded, as of November 2011, 36 small grants to 32 NGOs

to help increase demand for and the availability of TB and TB/HIV services

Where we work

Province District

Western Cape 1 Cape Winelands

Northern Cape 2 Siyanda

Eastern Cape3 NMMM

4 Amathole

Free State

5 Motheo

6 Lejweleputswa

7 Fezile Dabi

North West

8 Dr Ruth Mompati

9 Ngaka Modiri Molema

10 Dr Kennteth Kaunda

KwaZulu Natal

11 UMgungundlovu

12 eThekwini

13 UMkhanyakude

14 Zuzuland

Mpumalanga15 Gert Sibande

16 Nkangala

Limpopo17 Sekhukhune

18 Waterberg

Gauteng

19 Tshwane

20 Metsweding

21 Sedibeng

2

1

4

3

6

5

7

18

17

19

21

20

8 109

16

15

1211

1314

University Research Co., LLC • Block B, Rigel Park Offices • 446 Rigel Avenue • South Erusmasrand 0181 [Pretoria suburb] • South AfricaTel: 27-12-484-9300 • www.urc-chs.com • www.tbsouthafrica.org

Improving systems to empower communities