Tuberculosis Programming at PACE
Background

For the last 10 years, PACE has enhanced demand creation for Tuberculosis (TB) prevention and treatment services. Uganda is still among the 30 high burden TB/HIV countries in the world despite making significant progress in controlling TB. The annual TB incidence is 200 cases per 100,000 population, TB/HIV co-infection rate 40%.

Due to the stringent measures including lockdowns adopted by the government of Uganda to control the spread of COVID-19 since March 2020, reductions in case detection and treatment monitoring are projected to result in increased TB transmission, morbidity and mortality. TB reports revealed that as of week 23 in the year 2021, national TB case finding was at only 43% with the Acholi and Lango regions both in Northern Uganda contributing only 32% and at 55% respectively while and Bugisu region in Eastern Uganda contributed 41%.

Figure: National weekly trends in TB screening, diagnosis and reporting, Uganda Wk1 2020 to Wk23 2021

Source: Ministry of Health
Coverage of PACE’s TB Programmes

TB Programming is integrated into PACE’s HIV and Malaria activities. TB activities are implemented in Central, Northern and Eastern Uganda.

Key Target Groups: Key Populations, People Living with HIV, Priority populations, Children under 5 years and their care givers, Adolescent Girls and Young women (AGYW), Multi Drug Resistant MDR) patients

Goal: To Contribute to the reduction in the incidence of TB by 20% from 200/100,000 population in 2019/20 to 160/100,000 by 2024/25.

Objectives

SO1. To create awareness about TB and increase the proportion of people with TB symptoms that
seek appropriate care from health facilities from 61% to 90% by 2024/25
SO2. To increase TB preventive treatment coverage among eligible people to 90% by 2024/25
SO3. To increase TB treatment coverage from 76% to >90% by 2024/25
SO4. To increase TB treatment success from 72% to >90% by 2024/25
SO6. To build effective and efficient systems that ensure quality, equitable and timely TB
services

Strategies:

  • Strengthen community systems.
  • Functionalize the community systems/ structures at district and sub-county levels and engage them in TB service delivery; and create coordination mechanisms for community TB actors at sub-county, district and national level
  • Build capacity for contact investigation of Community Health Workers ( VHTs, CoRPs, mentor mothers, Peer educators) strengthen their linkage with health facilities
  • Building capacity for contact investigation of health workers and community health workers to e and
  • Strengthen TB prevention, diagnostic and treatment services including adoption of new technologies, drugs and approaches for screening, diagnosis and treatment
  • Capacity building of health workers to carry out case detection and diagnosis
  • Adopt digital/mobile technologies e.g. SMS to raise awareness about TB
  • Adopt use of technologies to improve adherence to TB treatment
  • Strengthen information management including digital technology
  • Strengthen provider skills for TB case management and use of data for continuous quality improvement
  • Improve Public and Private sector participation in reporting through DHIS2
  • Strengthen TB data use for planning at health facility and District Level