Community Health Workers take TB fight head on

by Amref Health Africa

“WHEN someone talks about staring death in the face, I know exactly what it means, literally, because I practically stared death in the face,” These words of courage, to some people, might reflect the life of seasoned soldiers who have spent painful hours in the battle field, but they actually belong to Samson Mwita, the 43-yearold who did not survive live bullets and hand grenades, but tuberculosis.

Tuberculosis (TB) is the world’s top infectious killer today. It is airborne and can affect any one of us. Over 5 000 women, men and children still die each day from TB.

The social and economic impacts are devastating, including poverty, stigma and discrimination. What some people might not know is that getting TB does not spell a death sentence, because this disease is curable and preventable, yet global actions and investments fall far short of those needed to end the global TB epidemic.

Recently, Amref Health Africa Tanzania through its USAID Afya Shirikishi project, funded by the United States Agency for International Development (USAID) Tanzania, donated 710 bicycles and 859 sputum collection and transportation boxes/kits for Community Health Workers (CHWs) in eight regions, namely Dar es Salaam, Geita, Katavi, Kigoma, Mwanza, Pwani, Rukwa, and Songwe.

The USAID Afya Shirikishi project aims to increase access to and improve Tuberculosis (TB) services and reproductive health services at the community level.

“The project focus at reducing the transmission and progression of tuberculosis through improved community-based service delivery; strengthen access to and use of quality community family planning services; improve the transparency, feedback, and access to data related to TB programming; strengthen the national TB policy and guidelines; and increase leadership and political support for TB as a public priority,” says the Amref Country Director, Dr Florence Temu.

Dubbed “USAID Afya Shirikishi”, she says the five-year project is funded by USAID in Tanzania and is being implemented by Amref Health Africa in Tanzania in partnership with Tanzania Communication and Development Center(TCDC);Mwitikio wa Kuthibiti Kifua Kikuu na Ukimwi Tanzania (MKUTA) and Service Health and Development for People Living Positively with HIV/ AIDS (SHDEPHA+ Kahama), under the guidance of the Ministry of Health, Community Development, Gender, Elderly and Children, Zanzibar Ministry of Health and President’s Office Regions Authority and Local Government, and Ministry of Education (MOEST).

Dr Temu says that Amref Health Africa Tanzania will continue to adhere to the guidelines issued by the Ministry to ensure compliance with national health policies and guidelines.

She says the donations will enable the CHWs to increase access to high quality, comprehensive and integrated health services in their communities by improving services provision of TB and reproductive health services.

“It will reduce significantly the time spent in walking long distances and carrying the sputum, handling containers but also ensuring that the same reaches the collection center in a timely manner,” she says, adding that it will eventually strengthen the community health program, leading to reduction of TB progression and increased provision of reproductive health services.

Deputy Permanent Secretary in the President’s Office – Regional Administration and Local Government, Dr. Grace Magembe, who was the guest of honor during the event, said that the government has continued to give priority towards primary health services.

Dr. Magembe acknowledged Amref, saying the project is a good step in addressing the fight against TB in the country.

“Through the Ministry of Health, we are very grateful for these bicycles and sample collection and transportation boxes that will be used in all project regional in the country,” said Dr. Magembe.

Tuberculosis is a potentially serious infectious disease that mainly affects the lungs. The bacteria that causes tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes.

USAID Health Office Director, Ananthy Thambinayagam says through the initiative of Amref, the United States Government will continue to support and work with Tanzania, development partners, NGO’s, local CSOs and other stakeholders to jointly work to improve health system of the of Tanzania.

Amref says that the project, among other things, aims to address priority gaps in community-based case finding for TB in the nine regions of Mainland Tanzania and Unguja Kaskazini and Mjini Magharibi in Zanzibar by 2025. The project will also address unmet Family Planning (FP) needs through community interventions in four regions of Katavi, Kigoma, Rukwa, and Songwe.

The 2020 National Tuberculosis and Leprosy Program (NTLP) external Joint end-term review (NSP 2016-2020) found that there is an enabling environment for Tanzania to scale up the community, advocacy, and remove gender barriers towards increasing TB notification.

In 2014, TB notification contribution from the community was 14 percent, whereby a target was set to reach 19 percent by 2020. However, the achievement was at 26 percent due to a high level of commitment to addressing community and patient barriers to access highly motivated ex-TB patients’ groups and community leaders, and regular and standardized enablers for ex-TB patients’ groups.

Tanzania Demographic Health survey of 2015/16 shows the use of modern contraceptive methods for married women to be at 32 percent while the national target for modern Contraceptive prevalence (mCPR) is set at 47 percent by 2023. The unmet need for Family planning has remained between 22 percent and 24 percent for almost 20 years now.

Amref Health Africa in Tanzania through USAID Afya Shirikishi activity is collaborating with Tanzania Government and other stakeholders to employ innovative approaches to address priority gaps in TB case finding in 9 regions and address the unmet needs for FP at the community in the four regions with the highest need.

In this project, Amref says the USAID Afya Shirikishi project focuses on working with the community structures to deliver TB and Family planning services.

The project works with the existing community platforms which are instrumental in reaching the families and individuals in their locality on health issues. Amref works with Community health workers, volunteers, accredited drug dispensers (ADDO), Traditional healers), bodaboda risers, local influential leaders, and local civil society organizations.

Community health workers work in a hard to reach areas that are featured with long distances and poor infrastructures in providing TB and FP services to their community.

The community health workers need some enablers like Bicycles to help reach as many communities as possible as well as other enablers like raincoats, boots, sputum handling containers, and backpacks for tools.

USAID Afya Shirikishi project in Year One has engaged a total of 735 community health workers who work directly with the community in active TB case finding, TB contact investigation, strengthening community referrals to the health facilities, mobilizing and creating awareness, and demand creation for FP services from the communities.

Article first published on

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