Project Fact Sheet | South Africa

What the project was USAID’s commitment to accelerating the implementation of improved basic TB services and MDR TB services in South Africa led in 2004 to the award of the five-year USAID Technical Assistance and Support Project/ Tuberculosis (TASC II TB) to University Research Co., LLC (URC).

Through this project, URC provided assistance to the South African National TB Control Programme (NTCP) and other stakeholders to strengthen local capacity to detect, treat, and prevent TB as well as further integrate TB treatment with HIV and other health care services and develop community-based strategies to ensure patients seek out and adhere to treatment.

Rather than comprising a vertical framework, the project was designed to encourage overlap and collaboration around a broader goal of improved treatment for TB and TB/HIV. Interventions aimed to:

¡ Improve the quality of TB services

¡ Increase availability of TB treatment

¡ Increase demand for TB services

¡ Improve management of TB support systems

¡ Introduce and scale up innovative approaches for expanding DOTS

How we workedThrough TASC II TB’s strong relationships with the NTCP, provincial and district health authorities, the targeted facilities and their surrounding communities, the project was able to accomplish an array of activities ranging from development of national policies and guidelines for infection control, TB/HIV, MDR/XDR TB, and advocacy, communication, and social mobilization.

Through an ongoing process of training and direct mentorship to introduce new technical capabilities to support TB control, the project helped link health service providers to community groups and non-traditional partners such as private sector business to build an integrated network of TB and TB/HIV treatment and care services stretching from the community, district, and provincial levels. Through collaborative engagement, the project reinforces district and provincial HIV and health systems strengthening objectives.

TASC II - Tuberculosis2004-2009

URC Project Coordinator, clinic staff, and community health workers in Eastern Cape

Where we workedIn addition to activities at the national level, the TASC II TB project provided support in five provinces: Limpopo, North West, Mpumalanga, KwaZulu Natal (KZN), and Eastern Cape.

South Africa

Provinces TASC II TB worked in

October 2010

Key achievementsTuberculosis¡ The case detection rate in supported facilities reached the

WHO target of 70%.

¡ Successful treatment completion increased from 65% to 85% and treatment default rates were halved from 18% to 9%.

¡ Improvements in cure rates in the project focus districts increased by 10% on average.

A model for training using TB/HIV collaborativesThese peer-review processes periodically brought together all personnel within the area responsible for TB services to present the results of their work, discuss, compare, and interpret the results, identifying challenges and discussing solutions to problems encountered.

Truly supportive methods of supervision that focus on coaching and mentoringThe project’s TB coordinators provided invaluable support and individual attention to the health care workers they worked with.

University Research Co., LLC • Block B, Rigel Park Offices • 446 Rigel Avenue • South Erusmasrand 0181 [Pretoria suburb] • South AfricaTel: 27-12-484-9300 • www.urc-chs.com

Clinic map of community DOTS supporters

Improving systems to empower communities

TB/HIV Integration¡ A strong increase in the numbers of HIV patients screened for

TB and TB patients tested for HIV in the majority of facilities.

60%

50%

40%

30%

20%

10%

0%Q1

2005Q1

2008Q4

2007Q3

2007Q2

2007Q1

2007Q4

2006Q3

2006Q2

2006Q1

2006Q4

2005Q3

2005Q2

2005Q2

2008

Cure Rate

Cross-screening for TB for HIV100%

80%

60%

40%

20%

0%Oct 06–Sep 07 Oct 07–Sep 08 Oct 08–Sep 09

% TB patients tested for HIV% HIV+ screened for TB

Best practicesThe use of a standard analytical tool to improve quality of servicesBy using tools such as the District Rapid Assessment Tool (DRAT), provinces could analyze routine information to monitor progress and identify challenges.

The management and use of strategic informationWith support from TASC II TB staff to collate, present, and evaluate the results of their work systematically and formally, staff of the facilities could reflect, analyse and identify obstacles to progress toward quality-of-care objectives within their own context.

Natural VentilationT B I n f e c T I o n c o n T r o l

Printing of this material has been made possible through support provided by USAID through the TASCII TB Project managed by University Research Co., LLC

TB is caused by an organism called

Mycobacterium tuberculosis and can

be spread from person to person

through the air

Cause of TB

Controlled natural ventilation can reduce

the risk of spreading TB by diluting the

concentration of particles in room air, such

as droplet nuclei containing M. tuberculosis

Natural Ventilation

TB suspects and cases should be placed in

a separate well-ventilated area and provided

with a surgical mask or tissues to cover

their mouths or noses while waiting

TB Patients

Health care staff should position

themselves closest to the clean air source

and patients closest to exhaust fans

to ensure proper airflow

Health Care Staff

(quarterly health facility data)

(quarterly health facility data)