The National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program) hosted the Green Light Committee (GLC) for a two-week evaluation of the TB Program in Kenya.
Visit to CHS Supported Murang’a County Hospital
While at Murang’a County Hospital, that receives support from CHS through its CDC funded Tegemeza project, the GLC team was greatly impressed by CHS support for various operations at the facility. Murang’a County Director of Health Dr Winnie Kanyi, and the Acting Medical Superintendent Dr Fredrick Mbugua, officially received and welcomed the team to the facility. Records from this facility showed great success in TB treatment with an 87.5% and 100% cure rate recorded in the 2013 and 2012 cohorts, respectively. Patients are still undergoing treatment in the 2014 and 2015 cohorts.
A Lab technician at Murang’a County Hospital (left) takes the GLC team Dr Saidi Ewagga and Dr Wilfred Nkhoma, GLC Head of mission through the lab records at the lab as Titus Kiamba of CHS looks on.
In addition, the clinical review meetings particularly amazed them. “Kenya is the only country among the 47 we have visited in Africa that has this outstanding practice of bringing together Drug-Resistant TB (DR TB) patients and their health care workers,” they noted. This is a monthly practice that brings together patients, caregivers and the health workers to review the progress of the drug resistant TB patients.
Through the CDC-funded Tegemeza project, and working with the County Health Management Team, CHS supports the facility to implement robust TB control activities. This includes DR-TB surveillance and quality management of patients under the programmatic DR-TB framework. As part of DR-TB care, patients are subjected to a pre-treatment evaluation and counselling session.
Clinical Review Meetings
The clinical review team is comprised of a multi-disciplinary group that includes: a physician, the county and sub-county TB coordinator, a nutritionist, lab officer, social worker, pharmacist, public health officer, Directly Observed Treatment (DOT) nurse and a representative from CHS. These CHS supported forums enhance the commitment of the patients to treatment and drug adherence.
The meetings also provide a relaxed platform for the patients to share experiences through their treatment journey. CHS is dedicated to improving the coordination from facility to community and has established the Private Public Partnership (PPP) with Lancet Kenya through the TB ARC Activity. Lancet has made it easy carry out laboratory investigations for both baseline and follow ups in facilities where there are inadequate lab equipment. With the PPP plan, the quality of care has greatly improved and TB patients do not incur any costs while undergoing treatment.
The GLC is a technical team from the World Health Organization (WHO), contracted by the Global Fund to Fight AIDS, Tuberculosis and Malaria to drive the Implementation Through Partnership (ITP) project.
During the introductory session at the NTLD-Program, Dr Joel Kangangi, from WHO welcomed the GLC team to Kenya. “The main aim of the visit is to address the ITP action which is the expansion plan based on new evidence, as well as discussing the way forward,” he said. Kenya is one of the high burden TB countries, making it a beneficiary of the Global Fund financial support for combating drug resistant TB.
While addressing the NTLD-Program team, the GLC Head of Mission, Dr Wilfred Nkhoma particularly commended the country for undertaking the national TB prevalence survey. The survey is one of the strategic activities geared towards the increase of TB case finding in response to GF priorities. “As focal point person for the first African TB prevalence survey, I am impressed by the speed at which Kenya is undertaking this exercise,” he said.
The GLC team had a chance to visit TB control partners and activity sites in the country including the Kenya Pharmacy and Poisons Board (KPPB), Kenya Medical Supplies Authority (KEMSA), MSF Green House and Vihiga County TB Prevalence Survey sites. They also visited other TB facilities like St Veronica Health Centre and the Murang’a County Hospital and GeneXpert lab
From Left : Dr Kahura of Murang’a County Hospital, Dr Saidi Ewagga from GLC, TB ARC Deputy Chief of Party Dr Lorraine Mugambi, and GLC Head of mission Dr Wilfred Nkhoma, during the clinical review meeting at Murang’a County Hospital
About GLC
The Global Fund provides support to scale up programmes through partners. In its support, it has agreed on goals and targets that need to be achieved from time to time. In this regard, Global Fund sends a technical assistance and advisory support team every year to address specific issues under the agreed objectives.
The technical team particularly evaluates implementation of the Programmatic Management of Drug-resistant TB (PMDT) in countries around the world. Further, it monitors implementation of financial components of the program and provides recommendations for each country’s needs in its TB implementation strategies.