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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 fode.simaga@undp.org 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 fode.simaga@undp.org Cancun 2009
Contents Introduction • History of the project implementation • The community response strategy • Program Structure • 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 center Complementarity and synergy between community and health institutions with actions at national and regional levels
NTP 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)
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
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)
III- Program 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.
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).
