Involvement of community-based organizations in the fight

against Tuberculosis and TB/VIH co-infection in Burkina

Faso

Dr Fodé SIMAGAfode.simaga@undp.org

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).