ACSM TA KENYA’S Experience By Jane Nyangara Onteri Programme officer Division of Leprosy, TB and Lung disease ACSM at country level sub-group Working Group.

ACSM TA KENYA’S Experience

By Jane Nyangara Onteri

Programme officerDivision of Leprosy, TB and Lung disease

ACSM at country level sub-group Working Group Meeting

At Southern Sun Hotel- Cape Town

5th -6th November 2007

Kenya

BackgroundRepublic of Kenya covers an area 582,646 sq

kms About 80% of its land is arid or semi-arid and is

sparsely populated Population was projected to be 33, 829, 590

(est. 2005): Life expectancy had dropped from 56.8 years in

1992 to 51 years in 2004 due to the AIDS epidemic

GDP (2006 est.): $22.79 billionAnnual economic growth rate (2006): 6.1%Gross national income per capita (2006): $455

Background cont.

Kenya is ranked 10th among the world’s 22 countries with a high TB burden.

Kenya’s TB burden and rates have increased dramatically — a more than tenfold increase from 10,000 in 1987 to 115,234 in 2006.

Case notification rate increased from 110 per 100,000 population in 1987 to 325 per 100,000 in 2006

Background cont.

TB treatment success rate stands at about 81% as of 2005

TB case detection rate of sputum smear positive cases (SS+) has remained low, at about 45% (WHO, 2007)

ACSM TASK Force.

Formed in 2005 Terms of reference are:

To develop strategies for the implementation of ACSM activities

To promote multi-stakeholder involvement in the implementation of ACSM activities

ACSM Task Force TORs Cont.To develop suitable health care worker

training programs, training manuals/guides and other materials to promote best practices in the implementation of ACSM activities

To develop suitable indicators for monitoring and evaluation of ACSM activities

To hold quarterly ACSM review meetings

The ACSM TASK Force Cont-- TASK Force Membership

DLTLD-Focal persons for ACSM (MOH) DLTLD-Focal person for CB-DOTS (MOH) PATH (Partner) FHI (Partner) AMREF (Partner) NASCOP (MOH) PSI (Partner) NEPHAK (Partner) Division of Environmental Health (MOH) Division of Health promotion (MOH)

TA for ACSM

For formation of Task forceDevelopment of R5 GFATMDevelopment of advocacy and

communication strategy documentsDevelopment of overall TB strategic plan

2006-2010.Development of TB M&E framework

Tools developed for ACSM

National TB/HIV Communication strategy was developed and launched (Lights of Hope)

DLTLD National strategic plan -2006 to 2010 developed (issues on ACSM addressed)

Monitoring and Evaluation framework for DLTLD has been developed (ACSM Addressed)

Development of the National Advocacy Strategy to Fight TB/HIV is in progress (draft is available)

TB community sensitization guide for community, business and religious leaders (Draft available)

National Communication strategy

The communication strategy was developed and launched March 2007 (Lights of Hope) It addresses issues of

symptoms, diagnosis and treatment and communication channels

National Advocacy strategy

National Strategy to Fight TB/HIV draft is available It address issues of

policy, stakeholders/

development partners, TB/HIV collaboration human resource and

logistics

FundingACSM is funded by GFATM round 5 The main objectives in the Round five

proposal were:To advocate for development of

supportive policies and increased funding for TB programs

To increase awareness and knowledge on TB and reduce its associated stigma in the general public and people with TB/HIV

Funding cont.

To mobilise the community and build its capacity to respond to the TB epidemic

To monitor and evaluate ACSM Activities

Apart from Global fund and GOK, the program also receive funds from CDC and WHO for ACSM activities

ACSM Achievements Advocacy

TB/HIV advocacy strategy draft is in progress A task force on ACSM formed, functioning and

meets on quarterly basis Communication

TB/HIV communication strategy has been developed and disseminated

Mass media campaign on going Magnet theatre trainings going on –Over 600

persons trained on TB/HIV Quarterly newspaper advertisement done and on

going Production of IEC materials- Posters, Brochures, T-

shirts, pamphlets, leaflets, flyers, stickers, spin wheels

Achievements cont. Social Mobilization

Public health Officers sensitized on ACSM- 73 /80 districts(91.25%)

Civic and religious leaders sensitized in 32/80 districts(40%)

Training and retaining of TB ambassadors on going Peer to peer education at workplace on going-

about 599 persons from different companies trained on TB/HIV

Survey on private DOTs providers offering low cost TB services and those willing to do so on going

Specific Activities 1.Mass Media campaign 2007

TV - Citizen, KTN, NTV between 8pm - 9pmMakutano Junction a TV 30 minutes program

supported by CDC on going.Radio spots- Citizen, Easy, Ramogi, Inooro,

Kameme, Simba and Mulembe. Time: between 6am - 9am and 4pm - 7pm

Radio 30 minutes call in show – 12 shows done with 12 TB/HIV topics

Print – Nation, Taifa leo and Standard Newspapers

Mass media campaign cont.

Media July spots

August spots

October/Nov. spots

Total of spots

Print 5 6 9 20

Radio 103 365 12 480

TV 16 10 0 26

Total 515

New paper adverts

Newspaper adverts cont.

Newspaper advert

2. IEC Materials produced

3. T-shirts

Monitoring and Evaluation

Campaign placement is being monitored through Steadman’s media monitoring service, to ensure that commercials are aired correctly and according to schedule

Support supervision is being offered to the districts and the provinces on ACSM

A survey will be carried out on the impact of ASCM activities soon

Challenges

How to increase case detection and treatment success rates

Reduction of defaulter rates and out of controls Prevention of emerging MDR-TB How to motivate and increase staff morale How to integrate TB services with other public health

services How to build a cohesive provincial and District teams How to reduce TB/HIV stigma Human resource issues such as shortages and

training

Conclusion

TB progam in Kenya is well managed, working and with continued support that we are currently receiving, we envisage significant reduction of TB cases and hope to reverse the trends

Let us join hands together and fight TB

THANKS