B. Tuberculosis (TB) Prevention, Control, Care & Support Program

Program Area One: Early Detection and Control of Tuberculosis

Tuberculosis (TB) remains a significant global health challenge, with millions of new cases reported each year. Early detection and timely intervention are crucial in preventing the spread of the disease and reducing its impact on affected individuals and communities. This program aims to implement a comprehensive strategy for the early detection and control of tuberculosis, leveraging innovative technologies, community engagement, and healthcare system strengthening. We intend to expand on this program implementation upon accessing external funding from global and international partners and scale up our program objectives as stipulated below:

Strategic Program Objectives (SPO):

• Develop and implement a robust early detection system for tuberculosis.
• Strengthen healthcare facilities and systems for effective tuberculosis control.
• Enhance community awareness, engagement, and participation in tuberculosis prevention and control efforts.
• Establish a sustainable monitoring and evaluation framework to assess program outcomes.

Program Activities:

1. Early Detection System:
   • Strengthen laboratory infrastructure and capacity for accurate and timely diagnosis of tuberculosis, including GeneXpert testing, culture, and drug susceptibility testing.
   • Train healthcare providers on updated diagnostic algorithms and techniques.
   • Expand access to diagnostic facilities in underserved areas through mobile diagnostic units or telemedicine platforms.
   • Implement active case-finding strategies, targeting high-risk populations, such as household contacts, healthcare workers, and individuals living with HIV/AIDS.
2. Healthcare System Strengthening:
   • Enhance the capacity of healthcare providers through comprehensive training programs on tuberculosis prevention, diagnosis, treatment, and infection control.
   • Improve the availability and accessibility of tuberculosis drugs and treatment regimens.
   • Strengthen the supply chain management system to ensure uninterrupted availability of essential tuberculosis medications.
   • Establish robust monitoring and reporting mechanisms for accurate data collection, analysis, and reporting of tuberculosis cases.
3. Community Engagement:
   • Conduct community awareness campaigns to educate individuals about tuberculosis prevention, symptoms, and the importance of early detection.
   • Train community health workers and volunteers to facilitate case identification and referral.
   • Promote active participation of community members in contact tracing and directly observed treatment.
   • Establish support groups to provide psychosocial support to tuberculosis patients and their families.
4. Monitoring and Evaluation:
   • Develop a comprehensive monitoring and evaluation framework to assess the implementation and impact of project activities.
   • Regularly collect and analyze data on tuberculosis cases, diagnostic outcomes, treatment adherence, and community engagement.
   • Conduct periodic evaluations to identify areas of improvement and adjust project strategies accordingly.
5. Stakeholder Collaboration:
   • Collaborate with national tuberculosis control programs, local health authorities, and international partners to align project activities with existing strategies and resources.
   • Engage with non-governmental organizations, community-based organizations, and civil society groups to foster collaboration and resource mobilization.
   • Establish partnerships with MOH and other research institutions to facilitate knowledge exchange and innovation in tuberculosis control.
6. Budget and Resources:
   • The estimated budget for this program shall be available upon request with detailed cost breakdown.
   • Resources required include personnel, training materials, laboratory equipment, diagnostic tests, medications, community outreach materials, and monitoring and evaluation tools.
7. Sustainability Plan:
   • Develop strategies for the integration of tuberculosis control activities into the existing healthcare system.
   • Strengthen the capacity of local healthcare facilities to sustain early detection and control efforts beyond the project duration.
   • Foster partnerships with both international and local organizations and stakeholders to mobilize resources and ensure long-term funding for tuberculosis control programs.

Conclusion:

This program outlines a comprehensive approach to early detection and control of tuberculosis. By implementing a combination of innovative technologies, healthcare system strengthening, and community engagement, we aim to reduce the burden of tuberculosis and improve the overall health outcomes of affected individuals and communities. We seek support and collaboration from funding agencies, governmental bodies, and international partners to make this program a success and contribute to the global fight against tuberculosis.

TB Program Area Two: Addressing Human Rights-Related Barriers to TB Services & Community Rights & Gender (CRG) Services:

Since 2020, KARUCAN Foundation (KAFO) has been participating in the existing programs of the Ministry of Health, through the Kasese District Health Office, that aim to remove human rights-related barriers to TB services and Community, Rights & Gender (CRG) Services. These programs include:

1. Training/Mentoring of Healthcare Workers on Human Rights and Ethics Related to TB:
   • Support routine assessments of health workers’ knowledge, attitudes, and behaviors towards people living with HIV and people with TB and support health administrators to identify and address any issues.
   • Support in-service training of health workers and health managers in hard-hit areas on human rights and medical ethics relevant to HIV and TB services.
   • Train health facility managers to implement routine surveys of health care worker attitudes about people with TB to inform training needs and policy changes at the facility level.
2. Reducing Gender-Related Barriers to TB Services:
   • Advocate with Kasese District Health Office/MOH to reorganize the delivery of TB and HIV services to ensure that services are sensitive to gender issues to maximize health outcomes.
   • For women, establish gender-sensitive TB and HIV diagnostic and treatment services.
   • For men, identify entry points into broader work being done to improve men’s health-seeking behaviors and integrate awareness of TB symptoms and treatment into these efforts.
3. Reducing Stigma and Discrimination:
   • Support community-level structures, such as Community-Based Groups, to implement stigma reduction campaigns.
   • Train village health teams (VHTs) and community health education workers (CHEWs) to sensitize communities about TB (i.e., what causes TB, how it is transmitted, and whether it can be cured) and the causes/effects of TB-related stigma and discrimination.
4. Programs in Prisons and Other Closed Settings:
   • Work on prisoners’ rights to increase advocacy and interventions for prisoners related to TB, such as nutrition for people living with HIV and/or TB.
   • Participate in a national-level assessment of human rights-related vulnerabilities and barriers relevant to TB and HIV to fully elucidate the situation in prisons.
5. Mobilizing and Empowering Patient and Community Groups:
   • Support the formation of networks of people affected by TB and advocate for human and patient rights related to TB, issues around gender inequality that increase vulnerability to TB, and rights to protective workplaces.
   • Conduct stakeholder meetings to explore creating/supporting networks and expanding community engagement in TB-related human rights.

Program Impact Indicators:

• At least over 5,000 people have been reached and empowered about TB Prevention/Control, and we will triple the number upon accessing external funding.
• Number of TB Clients/Survivors and their caretakers trained in early detection and prevention of TB.
• Number of people sensitized on TB risk factors, signs, symptoms, diagnosis, complications, and management.
• Number of schools visited/reached on TB prevention through School Health Programs.
• Number of training/mentorship programs conducted for healthcare workers on human rights and ethics related to TB.
• Number of healthcare workers mentored and trained on human rights and ethics related to TB.
• Number of people reached by TV programs, media campaigns, and other TB awareness activities.
• Number of reports published.
• Number of TB Clients/Patients mobilized and empowered on Community Rights and Gender (CRG) issues in accessing TB Care Services.
• Number of reduced gender-related barriers to TB care services.
• Number of prisons visited and trained on CRG issues for effective TB Care Services.
• Number of baseline and end-line KAP surveys/Community Needs assessments conducted showing substantial improvement in TB prevention and care knowledge.

NB: We need a lot of external donor support to realize this impact.