During June, the TB/Integrated Services Team Lead for USAID Southern Africa, Ms Cindy Dlamini, visited the East Boom Community Health Centre (CHC) in uMgungundlovu Health District. The visit was facilitated by the USAID TB LON-SAFT Programme, implemented by THINK and the facility management team from the Department of Health. The aim of the visit was for Ms Dlamini to review the impact of the Direct Service Delivery (DSD) support that the USAID TB LON-SAFT Programme team is providing to the CHC. The TB LON Programme team consists of an enrolled nurse, an enrolled nurse assistant and a data clerk.
The Programme team’s support is focused on improving case finding and linkage to care at this high TB burden facility that serves approximately 20 000 people on a monthly basis.
Located close to the city centre of Pietermaritzburg, East Boom CHC not only serves those living in the city, but also many coming from neighbouring rural areas since it is easily accessible with affordable public transport. Most patients visit the facility for health services related to HIV, TB, teenage pregnancy, trauma and non-communicable diseases.
Implementing bidirectional screening for TB and COVID-19 was one of the first steps the team took to ensure that TB case finding improves. Since all visitors to the facility must first be screened for COVID-19 at the entrance, the USAID TB LON-SAFT team updated the screening tools to include TB symptoms. This resulted in more visitors being identified as TB presumptive cases and being tested for the disease.
Once diagnosed, the USAID TB LON-SAFT team supports patients with TB education and adherence counselling. TB information about their diagnosis and treatment is given in both English and isiZulu, the latter being the most spoken language in the district. The team’s data clerk assists the facility staff to capture all collected data in the TB registers and the national Tier.net TB and HIV reporting system. Monthly Data Quality Audits ensures data integrity and also ensures that patients are not being missed.
When a patient misses an appointment or cannot be contacted, a tracer or outreach team from the USAID TB LON-SAFT Programme is alerted to go and find the patient in their home. Often patients miss their appointments due to lack of transport or other personal reasons. The tracer teams are trained to counsel and support the patient to ensure that the patient completes their treatment journey.
During the visit to East Boom CHC, Shane Naidoo, the uMgungundlovu District TB Supervisor expressed his gratitude for the USAID TB LON-SAFT Programme saying that:
“With the addition of the USAID TB LON-SAFT team to uMgungundlovu district we have seen vast improvements around our TB program. Thanks to this partnership indicators are showing an upward trend and rapport with staff have improved through training sessions. Our heartfelt appreciation goes out to the USAID TB LON-SAFT team from THINK for the manner in which they have done business in our district and kept us on our toes”
The changes implemented by the THINK team have improved both TB case finding and linkage to care at the facility. The team’s initiative was also appreciated during a screening campaign at a nearby old age home where seven TB patients were diagnosed and initiated on TB treatment. The USAID TB LON-SAFT Programme team’s passion and enthusiasm is not only making a difference at East Boom CHC, but also in the surrounding areas.