washington d.c., usa, 22-27 july 2012 engagement of community volunteers for improving access to tb...
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Washington D.C., USA, 22-27 July 2012www.aids2012.org
Engagement of Community Volunteers for Improving Access to
TB and HIV prevention, treatment and care services in Ibadan, Nigeria: the
PLAN Foundation/TB CARE I Experience
Obatunde OladapoExecutive Director:
PLAN Health Advocacy and Development Foundation
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Background
• The TB/HIV twin epidemics should be addressed jointly at community level.
• PLAN Foundation engaged community volunteers (CVs) for improving access to TB/HIV prevention, treatment and care services in 5 Local Government Areas (LGAs) of Ibadan, Nigeria.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• 24 communities were selected from high TB-prone areas, high density areas and hardly-reached communities.
• A consensus meeting involving various community stakeholders was held during which 50 CVs were selected to facilitate active referral of TB suspects to DOTS centres and linkage with HIV testing services in ART clinics and other healthcare facilities in the areas.
methods
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Community stakeholders include
• TBLS in the LGAs• LACA Managers in the LGAs• CSOs working in the LGAs• Religious leaders • Reps of Private Medical Practitioners• TBAs/Voluntary Health Workers• Patent Medicine vendors• ATM Program Officers in the state
Washington D.C., USA, 22-27 July 2012www.aids2012.orgconsensus meeting in pictures
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• The CVs were trained on the basics of TB, suspects‘ identification, defaulter tracing, adherence support and TB/HIV relationships.
• They were involved in providing treatment support and follow-up services for smear-positive cases, linkage with HIV testing and treatment for dually-infected persons; and organizing community mobilization.
Washington D.C., USA, 22-27 July 2012www.aids2012.orgCVs training in pictures
Washington D.C., USA, 22-27 July 2012www.aids2012.org
community mobilization in pictures
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• Monthly CVs review meetings were held while PLAN Foundation staff provided supportive supervision to the CVs in communities.
• The monthly CVs review meetings provide opportunity for reviewing the work of the CVs, collating monthly reports of referrals and follow-up done by the CVs and addressing challenges that may be encountered on the field.
• The supportive supervision helps in sustaining linkages between the TBLS and CVs, ensuring that records of referrals by the CVs are properly kept and addressing issues needing urgent attention.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
monthly CVs meeting in pictures
Washington D.C., USA, 22-27 July 2012www.aids2012.orgsupportive supervision in pictures
Washington D.C., USA, 22-27 July 2012www.aids2012.org
sample of flyers produced
Washington D.C., USA, 22-27 July 2012www.aids2012.org
sample of flyers produced
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• There were steady and significant increases in number of TB suspects referred by CVs between project onset in June 2011 and October 2011.
• TB clients referred to DOTS centres for screening were: June - 47; July - 56; August - 118; September - 274; October - 238 totaling 733 for the period.
• Of these, 78 of the suspects were smear positive cases while 25 were dual infected with TB and HIV.
Results
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Monthly total referrals by CVs
06-yy 07-yy 08-yy 09-yy 10-yy0tan28a566028
0tan19a566019
0tan10a566010
0tan1a56601
0tan21a566021
0tan12a566012
0tan3a56613
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Total referrals by LGAs
Total (Jun-Oct 2011)0tan28a566028
0tan19a566019
0tan10a566010
0tan1a56601
0tan21a566021
0tan12a566012
IBADAN NORTHIBADAN N/EASTIBADAN S/WESTIDO ONA-ARA
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• Engaging CVs is effective in identifying, referring, supporting and following up TB suspects and persons infected with TB and HIV.
• CVs live in the community, understand the terrain in which they operate. Engaging them has proven very effective in contact tracing as well as defaulter tracing.
Conclusions
Washington D.C., USA, 22-27 July 2012www.aids2012.org
• There is the need for linkage of TB and HIV services as a strategy for detecting HIV infection among people with TB.
• Community mobilization through CVs helps to increase awareness about TB and HIV in communities.
• There should be improved support and motivation for CVs as vital linkages to communities TB/HIV interventions.
Washington D.C., USA, 22-27 July 2012www.aids2012.org
co-authors
• Amos F. Omoniyi
World Health Organization (WHO), TB/HIV Dept, Abuja, Nigeria,
• Emmy van der Grinten
KNCV / TB CARE I, Country Office, Abuja, Nigeria• Sunday A. AkinyosoyePLAN Health Advocacy and Development Foundation, Ibadan, Nigeria (PLAN
Foundation)
• Johnson K. AyoolaPLAN Foundation
Washington D.C., USA, 22-27 July 2012www.aids2012.org
acknowledgement
• PLAN Foundation is grateful for the funding provided for the project by TB CARE I which is a collaborative funding mechanism by USAID, KNCV and the American Thoracic Society (ATS)
Washington D.C., USA, 22-27 July 2012www.aids2012.orgThank you!