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Involvement of community-based organizations in the fight
against Tuberculosis and TB/VIH co-infection in Burkina
Faso
Dr Fodé [email protected]
Cancun 2009
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Contents
Introduction
I. History of the project implementation
II. The community response strategyIII. Program StructureIV. Challenges and Perspective
Conclusion
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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
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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.
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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.
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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;
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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
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II. Key point of the community response strategy (1)
A response-design with a participative approach
Taking into account health professionnals, community actors
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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
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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
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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
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III- Programme structure
The actors 11 Regional coordinating
networks: «structures pivot»- Role:
- coordination, - technical support, - financial support
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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
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Community sensitization activity using flip chart
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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)
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Psychological support to a patient
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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.
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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)
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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
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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;
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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)
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Challenges and perspectives 3
Global Fund Round 8 TB: - Starting probably in January 2010 - PAMAC is becoming PR new
challenges.
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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).
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