urc-swaziland monthly · pdf fileday which falls on the 24th of march. ... - why sd still has...

Improving systems to empower communities

The month of March was buzzing with activities building-up to the commemoration of World TB

Day which falls on the 24th of March. University Research CO., LLC (URC) staff played a critical

role in the preparations for World TB Day supporting the National TB Control Programme

(NTCP). The climax of the public awareness campaigns, in partnership with the Observer news-

paper was the joint interview conducted by the Sunday Observer journalist, Thembeka Dlamini at

the NTCP offices. The interview with the NTCP Programme Director, Themba Dlamini and the

URC Country Director, Dr Samson Haumba brought insight to readers on TB infection which still

remains high in the country, mortality rate and the different ages prone to infection. This interview

on the TB infections in Swaziland took place on the 21st of March 2014 and the article was pub-

lished on the 23rd of that month. After numerous effective TB day build-up campaigns and a

successful event, the Country director had a few words to share with the team:

FOREWORD BY THE COUNTRY DIRECTOR

I wish to congratulate all the staff who

participated in the world TB Day making

the day a memorable one with the pro-

duction of the IEC materials and the ban-

ners. The march from Msunduza communi-

ty to the Prince of Wales, where the main

commemoration was staged indeed left a

mark to those we were targeting.

The exhibition at the stalls and the excel-

lent presentation to the Minister of health

and the dignitaries, the punctuality and

time management and above all, the pro-

fessionalism of all URC staff. I also con-

gratulate the NTCP staff and the NTCP

programme manager on the successful

hosting of the event.

In the month of April, 2014, we look for-

ward to similar dedication and support to

the External National TB review. This is

when a team of international experts and

local experts will be participating in the a

comprehensive review of the achievements

of the 2010-2014 National TB Strategic

Plan, which URC is proud to have contrib-

uted to through planning and execution.

URC-SWAZILAND MONTHLY NEWSLETTER

March 2014 Issue

10 April 2014 Volume 1, Issue 3

Inside this issue:

The TB Newspaper Article

Series

2

TB Day at Bhalekane Cor-

rectional Center: Reaching

Inmates in Prisons

3

World TB Day Build-Up

Campaign: Radio Interviews

4


Campaign at Mhlume High

School

5

Hhohho Region: TB/HIV

Management TB, Quality

Improvement On-site Train-

ings

5

2014 National TB Day Com-

memoration: “Reaching the

7 000”

6

TB Day in Pictures 7

2014 International Ear &

Hearing Care Day: “Making

Hearing Matter”

8


Campaign: Reaching Pub-

lic Transport Sector

9

NTCP Innovate Path 10

TB Centre: Centre of Excel-

lence Work Plan Develop-

ment

11

Other Activities in March 12

Upcoming Activities in April 12

NTCP Programme Director, Themba Dlamini & URC Country Director, Dr Samson Haumba

during the interview.


Newspapers count as the second most

used media mediums in the country.

Publishing educational articles in one of

the two newspapers available in the

country meant a large audience would

be targeted.

The University Research CO., LLC in

partnership with the National TB Control

Program (NTCP) took advantage of the

popular medium, The Sunday Observer,

to publish a series of TB articles building

up to the day. The series of articles

consisted of four TB articles, which were

published weekly in the Sunday Observ-

er. The articles were drafted by the URC

team in collaboration with the NTCP.

What is even worth more noting, is that

the country has just recently celebrated

the Prime Minister’s, Dr Sibusiso Barna-

bas Dlamini, wedding. The paper fea-

tured the wedding pictures and because

of that copies sold at various outlets,

especially around the city were sold out.

This worked at an advantage for the

campaign, because on that week the

article published was on “Childhood

THE TB NEWSPAPER ARTICLE SERIES

URC-SWAZILAND MONTHLY NEWSLETTER March 2014

TB”, which is a topic normally ignored by

many.

Highlights from this activity were that five

articles were published, instead of the four

TB articles that were initially offered to be

released in the newspaper. For all the

articles the preparatory team was given

only half a page of the newspaper. In

effort of reaching more people, a big

spread was requested from the newspa-

per.

The team was privileged to have a Sun-

day Observer news reporter come to visit

the NTCP offices to conduct an interview

with the NTCP Programme Manager,

Themba Dlamini and URC-Swaziland

Country Director, Dr. Samson Haumba.

Information gathered from the inter-

viewed scored the team the bonus arti-

cle.

The TB article Topics:

- Basic Facts About TB - 2 March

- Multi-Drug Resistant TB - 9 March

- Childhood TB - 16 March

- World TB Day: Reaching the 3 million -

23 March

- Why SD Still has High TB Infections - 23

March

The five newspaper articles on TB

World TB Day Build-Up Campaign...


Two days after the actual commemora-

tion of World TB Day the USAID ASSIST

project supported the National TB control

Programme to expand and increase

access to TB services at the correctional

centre in Bhalekane.

Tuberculosis poses a real threat to the

general public, prisoners and warders

are no exception. Inmates suffer much

emotional and sometimes physical hard-

ship. Factors like overcrowding in the

prisons are an enabler of the spread of

tuberculosis infection. Coupled with

overcrowding poorly treated patients in

prison may spread multidrug resistant

TB to fellow prisoners and staff. When

released, they may infect their families

and the general population. Based on TB

management practices good treatment

and good tuberculosis control should be

easier in a closed, disciplined environ-

ment.

TB DAY AT BHALEKANE CORRECTIONAL CENTER: Reaching Inmates in Prisons

Volume 1, Issue 3

A representative delivered the speech on

behalf of the Correctional Service’s

Commissioner who shared the following

in his speech:

“In the study that was con-ducted in 2010 among the Correction-al Services in Swaziland, it was dis-covered that both inmates and offic-ers were also infected with the dis-ease. This assessment reported that TB prevalence was at 3 570 /100 000 populations among inmates and 1 900/100 000 population among offic-ers, which is above the national prev-alence of 907/100 000 population. This has prompted His Majesty’s Cor-rectional Services to take actions towards the reduction of the TB infec-tions in the department.”

Living in a confined environment, the

inmates were not left out in the efforts of

raising awareness on all TB implications.

Close to 300 inmates were given the

opportunity to learn about the basics on

TB, and ways in which they can protect

themselves. The health education was

not only beneficial for the inmates but as

well as the warders.

Providing health education was only the

first step towards fighting TB, the second

step was to have the inmates screened.

Shortly after it was announced that it

was time to screen, the inmates flocked

in their numbers near the TB screening

desk that had been provided for the day.

It was encouraging to see that the in-

mates took what they had just learnt

seriously, moving them to take part in

the fight against the spread of the dis-

ease.

TB Screening of inmates after the formalities of the ceremony.

Inmates queuing in line to be screened for TB.

NTCP Sibonsile Gamedze holding up some of the posters that were distribut-ed.

Inmates reading the BCC materials they collected from the stalls.


The World TB Day campaign brought TB

awareness to radio, the morning of the

21st of March 2014 in the nations popular

current affairs programme, at the coun-

try’s sole national radio station, the Swa-

ziland Broadcasting Information Services

(SBIS). The current affairs programme

formerly known as “Letishisako” main-

tains a high listener-ship as it is aired live

in the siSwati language, during the morn-

ing drive-time. The campaign took ad-

vantage of another morning radio pro-

gramme known as “Temphilo”, which is a

live show focusing on health issues. This

interview took place two days before the

set date of the country’s commemoration

of World TB Day, on the 27th of March.

For the first interview, representing the

World TB Day preparatory team, namely

the University Research CO., LLC (URC)

and the National TB Control Programme

for these specific activities, was represent-

ed by the NTCP Communications Officer,

Gcinile Mavimbela. The second interview

had one representative each from the pre-

paratory team. The interviews highlighted

the key objective of the day, which are

centred on this year’s theme, “Reaching

the 3 million” as well as raising awareness

about the disease. Also discussed during

the interview were the activities which will

take place on the day. Differing from the

first interview, the second interview focused

on TB in children, which is a normally over-

looked subject.

The interviews went on to touch on the TB

burden in the country and steps the country

has taken in a bid to fighting the disease.

Mentioned in the interview was the contin-

ued support that NTCP receives from the

University Research CO., LLC (URC) tech-

nically and financially, which has helped

reduce the impacts of TB on the nation.

.

TB AWARENESS VIA RADIO INTERVIEWS

Volume 1, Issue 3

NTCP, Nonhlanhla Dlamini and URC, Ntombifuthi Shongwe in the studio with Temphilo host Mthetho

Ka-Mose



Mhlume High School is located in the

Lubombo region, with a total of 15 clas-

ses. The numbers of children in the

school add up to seven hundred stu-

dents, with forty teachers and four sup-

port staff. The school reported that re-

cently they had two TB cases. The

school authorities then requested that

the Lubombo regional health team edu-

cates the school on the disease, infec-

tion prevention and control measures.

The USAID –ASSIST project supported

activities including health education,

MHLUME HIGH SCHOOL TB HEALTH EDUCATION

Volume 1, Issue 3

distribution of Behavioural Change Com-

munication (BCC) materials, screening

and sample collection. The health edu-

cation helped dismiss some misconcep-

tions and fears that a majority of the

children had. A total of 533 BCC materi-

als in both siSwati and English were

distributed to the school. Out of the 158

teachers and students screened, 129 of

them tested negative and 29 were posi-

tive.

This initiative clearly came at the right

time, as it will not only help reduce the

risk of exposure to individuals within the

school, but also save the lives of those

who could be infected with the TB dis-

ease.

The school authorities expressed their

sincere gratitude to the Lubombo region-

al health team for taking the initiative to

provide health education to the school.

What they found even more exciting is

that as a school they could now offer

adequate and informed support to stu-

dents and the staff.

The USAID ASSIST project mandate

is to apply science to strengthen and

improve Systems, with emphasis on the

use quality improvement methodologies;

with this as a foundation the project in

Swaziland hosted a number of Quality

Improvement (QI) trainings to help build

the capacity of workers in health facili-

ties and their practices. Some of these

trainings are hosted away from facilities

and sometimes not every healthcare

worker gets to attend. The project in a

bid to scale up and effectively build the

facilities of HCE at facility level had a

number of onsite QI training such as the

one , from the 11th to the 13th of March,

three trainings were hosted in the Hhoh-

ho region and were all on-site. The first

training on TB/HIV management was at

the Ezulwini Satellite Clinic and the oth-

er trainings that followed were both at

the Mbabane Government Hospital on

Quality Improvement. A total of 24 indi-

viduals, nurses and support staff, from

the three facilities benefited from the

trainings.

The clinic at Ezulwini is one of the model

clinics for the project. None of the staff

at that facility have been trained on TB/

HIV management, USAID ASSIST saw

it beneficial that they host the training

and that it be done on-site, reaching

more of the staff. Objectives of the work-

shop were to help capacitate health care

workers with the abilities to screen, sus-

pect and diagnose TB using the appro-

priate algorithms and to implement basic

TB infection prevention and control

measures. Another objective was to

impart knowledge and skills to man-

age TB patients and implement TB/

HIV collaborative activities.

It has been observed that implemen-

tation of Quality Improvement activi-

ties improves service delivery and

patient care. Therefore the training

held high significance to the two facili-

ties as it is evident in the objectives

that guided the training. The objec-

tives training were met to assist the

healthcare workers to develop a qual-

ity improvement project and tools for

the facility, which would in turn im-

prove service delivery at the health

facilities.

HHOHHO REGION: TB/HIV Management, Quality Improvement On-Site Trainings



In the early hours of Saturday morning, a

group of people gathered in the streets of

Msunduza to commence with their march

to the Prince of Wales Ground. In unison

and motivated by the idea of spreading TB

awareness to one of the highly populated

locations of Mbabane, the crowd marched

through the community into town carrying

banners and postcards on TB.

With the sounds of the military band echo-

ing in the streets of Mbabane city and the

visibly large and red banner printed, “TB

Awareness: Reaching the 7 000”, missing

the group and the message they were

sending became near impossible. Also a

part of the march was the Minister of

Health, Sibongile Simelane, heads of vari-

ous organisations, healthcare workers and

the people who were fished from their

homes and around town who willing joined

the celebratory bunch. Behind the march

was an ambulance vehicle with a louder

speaker inviting people to join in the com-

memoration of TB day.

Once the crowd arrived at the main cere-

monial grounds, a number of stalls had

been set up for the general public to visit.

This benefitted the public as the Minister of

Health paved the way for all present to

visit the different health desks. The Univer-

sity Research CO., LLC (URC) were more

than prepared for the day, as it produced

enough Behavioural Change Communica-

tion (BCC) material to hand out to the

crowd. A number of banners were pinned

up around the field each sending across

2014 NATIONAL TB DAY COMMEMORATION: “Reaching the 7 000”

Volume 1, Issue 3

informative messages on TB. A variety of

pamphlets printed in siSwati and English

allowed the public to pick a language

which they can easily understand. The

produced BCC materials did not leave out

children as there were informative TB

stickers which managed to capture the

attention of children. The stall lured people

of all ages ranging from children to an

elderly audience. More and more people

flocked the stall posing questions and

requesting to be screened for TB.

About 550 people were reached on the

day through informative speeches by dig-

nitaries, including that of the Minister of

Health. Inclusive as entertainment in the

programme was choral music by Ka-

Boyce High School (located in Msunduza)

and an educational play by S’momondiya

(loosely translated as ‘beautiful person’).

The comical but educational play told a

story about the dangers of TB and the

steps one can take to cure it and reduce

the spread of the disease. This play man-

aged to capture the attention of many,

assuring that the message about TB was

sent across.

Tb coordinators moving around managed

to reach the different groups that were

present on the day. The groups targeted

include the high school children, military,

police, mine workers and the general pub-

lic. Encouraging to see was the number of

people flocking the URC health desk to

ask questions and collect the Behavioural

Change Communication (BCC) materials

of which by the end of the day 1 149 of it

was disseminated. The people who visited

the URC stall amounted to about 250

people, of which 32 of them requested to

be screened.

The objective of the day was achieved as

all possible methods were explored to try

and raise awareness about the day. The

message was conveyed to a large audi-

ence especially those who made it to the

grounds. Those who did not make it to the

ground were not left out as they were also

sensitized on TB through the march.


Volume 1, Issue 3

2014 NATIONAL TB DAY COMMEMORATION AT THE PRINCE OF WALES GROUND

TB Day in Pictures...

Minister of Health, Sibongile Simelane

WHO Country Representative Dr Owen Kaluwa

1. The public flocking the URC stall to consult and collect BCC materials.

2. The public spotted with some of the TB pamphlets distributed on the day.

3. The audience listening to speeches deliv-ered on the day.

4. URC employee sharing some of the “Stop TB “ stickers with the public.

1

2

3

4

1

2

2

3

4

1. Dignitaries joined in the march from Msunduza to Prince of Wales grounds.

2.Ka-Boyce High School children marching to the stage before their per-formance.

3. URC TB Coordinator Nokuthula Mdluli leading former mine workers who were also a part of the march.

4. The military and the elderly march in the streets of Mbabane CBD.


There are 360 million persons living with

hearing impairment in the world, an esti-

mated 5.3% of the world’s population. In

Swaziland an estimated 65 000 people

cannot hear. What is encouraging though

is that 50% of these hearing loss cases

can be avoided through early diagnosis.

For the first time this year on the 3rd of

March 2014, the country joined the world

in the activities of commemorating World

Ear Care Day. This current year’s theme

was “Ear care can avoid hearing loss”.

The University Research Co., LLC (URC)

partnered with the Ministry of Health

(MOH), World Health Organisation

(WHO) to name a few, collaborated to

raise awareness on ear care and hearing

loss prevention. URC focuses its tech-

nical support on TB, and its involvement

on the day is linked with the side effects

caused by TB treatment, which is hearing

loss.

On the day, commemoration activities

started off with a formal gathering at the

Swazi Royal Convention Centre, in

Ezulwini. At this gathering as per the

objective awareness was raised on the

importance of taking care of ears. More

activities followed after the formal gather-

ing where the Minister of Health, Sibongi-

le Simelane was the guest speaker.

A group of healthcare workers then visit-

ed Mbuluzi Primary School where they

conducted medical checks-ups on a

group of first grade (grade 1) pupils. An

average of 50 children had their ears

examined and for those whose ears had

infections were attended to on the day.

Considering the fact that it was the first

time hosting this event, the turnout was

commendable and the activities conduct-

ed on the day were beneficial. The mes-

sage of ear care was shared to with the

audience in attendance through the

speeches, life experiences shared as well

as the numerous Behavioural Change

Communication (BCC) materials which

were disseminated on the day. Focusing

on the children from the school the ear

examinations helped improve the hearing

of a number of kids.

2014 INTERNATIONAL EAR & HEARING CARE DAY: “Making Hearing Matter”

Volume 1, Issue 3

The Minister of Health Sibongile Simelane delivering her speech also interpreted in

sign language.

WHO Country Representative Dr Owen Kaluwa who was about to deliver his

speech.

Gugulethu Mavimbela an Architect at

Ekhaya Properties shared his story

about living with hearing disability.

His story served as a motivation for all

at the event, that success is a possibil-

ity even for those who are deaf.

Attendants at the formal event held at the Convention Centre


This year’s World TB Day theme was set

out on identifying the missing TB cases, in

order to treat and cure these cases. The

USAID ASSIST project identified public

transport owners as part of the missed TB

cases that needed to be taught about TB

infection. On the 5th of March 2014, the

Infection Prevention and Control team

hosted a workshop to help sensitize Pub-

lic Transport Operators on TB/HIV pre-

ventative measures for the public

transport drivers and the general public

that use the mode of transport.

The 28 participants who attended the

workshop were trained on different topics

of which they were expected to share with

their employees as public transport own-

ers. Targeting an even larger audience, 500

‘Open Windows’ stickers were given to the

participants to disseminate to the different

public transport drivers. The stickers were to

be put in the vehicles for commuters to read

and to follow suite. Just a few days after the

workshop a number of these stickers were

identified in the different public vehicles.

TB transmission in public transport is at its

highest, because different commuters,

healthy or sickly board these vehicles daily,

exposing the next person to infections. Sen-

sitization on preventative practices are key to

fighting the disease and the provision of the-

se stickers counts as the first step to eliminat-

ing transmission in public transports.

Volume 1, Issue 3

TB IPC topics:

- TB transmissions and pathogenesis

- Overview of TB situation in SADCC Re-

gion and Swaziland

- TB IPC Control Strategies

- Care of employees regarding TB

BCC sticker distributed to the public transport owners, which has been

identified in public vehicles.

More Pictures from page 8...

URC Audiologist , Nomcebo Fakudze examining one of the children’s ears.

Dr Eunice Haumba, Ear Nose & Throat Specialist examining a child’s mouth.

Children’s ears being cleaned and objects being pulled out of the ear.

More tests were conducted to test the hearing of children.


REACHING THE PUBLIC TRANSPORT SECTOR


The National TB Control Programme offi-

cially went live on the web on the 28th of

February 2014. This was in the form of a

website, Facebook page, YouTube and an

informative blog. This was done in effort to

electronically manage systems and to run

online trainings reaching a wider scope.

With the support of the University Research

CO., LLC the NTCP has been able to secure

the web hosting services. This then means

that the NTCP can securely run the online

database for 24 hours seven days a week

and it is available worldwide.

This is not the only innovative path that the

TB Control programme has taken it has also

introduced patient mapping Geographic

Information System (GIS) with support of

URC in 2010, providing 4 GPS receivers, a

server and a GIS software. Later it was

expanded with an additional of 10 GIS ma-

terials, a computer server as well as a well-

trained Adherence Officer for the usage of

the gadget, procured by the World Health

Organisation (WHO).

Operation of patient mapping and data

collection has been coordinated centrally

from the programme last year in June. As of

that month the system has allowed Drug

Resistant- TB (DR-TB) patients to be a

priority. Almost a year later, out of the 10

gadgets 8 have been installed and are in

use. The more technology continues to

evolve TB loosens its burdensome grip on

people.

NTCP TAKES ON AN INNOVATE PATH

Volume 1, Issue 3

FEBRUARY EXTRA ...

The NTCP website, www.ntcpswaziland.com

The NTCP Facebook page, www.facebook.com/NtcpSwaziland

The NTCP YouTube page, www.youtube.com/user/NTCPtv

The NTCP Blog page,

www.ntcpswaziland.blogspot.com

A map showing DR-TB patients mapped with the GIS system.


In a bid to transform the TB Centre into a

Centre of Excellence (COE) in Swaziland,

The USAID ASSIST project provided tech-

nical assistance and support to the TB

centre, a TB specific treatment centre in

the Hub of Swaziland. The TB Centre

offers services to a population of 350 000

in the Manzini region and since TB centre

is centrally located in the country about

one third of the TB clients are served by

the centre.

On the 14th- 15th of March, the USAID –

ASSIST project hosted a residential train-

ing at the Bethel Court Hotel, in Emvutjini

to assist the facility to develop a work plan

for the year 2014, incorporating compo-

nents of the COE.

Another purpose of the activity was to

come up with interventions to close exist-

ing gaps and challenges faced by the

health facility.

Objectives guiding the workshop were to

establish the infection control committee

and establish a baseline for the TB screen-

ing surveillance on healthcare workers. To

develop the annual work plan participants

were divided into groups, where the

groups incorporating their inputs came up

with one vision for the facility.

TB CENTRE: CENTRE OF EXCELLENCE WORK PLAN DEVELOPMENT

Volume 1, Issue 3

An overall view of the workshop was a

success as the participants continued to

be conducive and productive in the posi-

tive atmosphere encouraged by the facili-

tators.

Together the participants managed to put

together objectives and activities into a

matrix. To continue motivating the team, a

team building session was included in the

programme. This provided an opportunity

for the team to share some happy mo-

ments in their workplaces and motivate

them to perform at their best and work

towards a centre of excellence status.

URC Country Director Dr

Samson Haumba (first

from left) posing togeth-

er with TB Centre team

during team building

exercise

URC TB Coordinator

Yvonne Makwabarara

conducting TB screen-

ing before departure

of the team


Upcoming Activities in April:

TB Program Review

QMP Quality Forum

Staff QRM

Lab Research Training

Reporting: Project QRM & semi annual Reports

Manzini Region Community TB Day

Progress towards accreditation( SMLTA) : Case

study Pigg’s peak hospital –laboratory

Regional sites visits

IPC Focal Person Post Training feedback ses-

sion

University Research CO., LLC (URC) 3rd Floor, North Wing, Building 1

Mbabane Office Park

Sozisa Road

P. O. Box 1404 Mbabane H100, Swaziland

Tel: (+268) 2404 7154/56/69

Fax: (+268) 2404 7199

Website: www.urc-chs.com

OTHER ACTIVITIES IN MARCH:

IPT Study

Project work plan review & planning

meetings

Staff monthly technical & data review

meetings

SHLS Strategic plan update meeting

EDITORIAL TEAM

Jilly B. Motsa

Janet Ongole

Dr Marianne Calnan

Dr Samson Haumba

URC– SWAZILAND

Who Are We…

University Research CO., LLC (URC) is dedicated to improving the quality of

healthcare, social services and health education worldwide.

Mission

URC’s mission is to provide innovative, evidence– based solutions to

health and social challenges worldwide.

Expertise

In Swaziland, URC expands access to and improves the quality of services

addressing infectious diseases including HIV/AIDS, TB, and improving laborato-

ry quality management system

Approaches

URC focuses on finding ways to deliver proven approaches to health care prob-

lems, applying quality improvement (QI) methods and conducting research and

evaluation to tailor those approaches to various settings. Recognizing imple-

mentation barriers unique to each setting, we train local managers and service

providers to apply QI methods to strengthen health systems, integrate system

elements, and bring improvements to scale. URC also specializes in designing

health messages and materials to educate target audiences about improving

health behaviors.

http://www.urc-chs.com/../../hiv/aids

http://www.urc-chs.com/../../tuberculosis

http://www.urc-chs.com/../../health_communication_and_behavior_change

http://www.urc-chs.com/quality_improvement

http://www.urc-chs.com/quality_improvement

http://www.urc-chs.com/research_and_evaluation

http://www.urc-chs.com/health_systems_strengthening

http://www.urc-chs.com/behavior_change_and_communication_2

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