Advocacy for 8000 TB affected persons in Mubende district Project
-The onset of political campaigns; we had anticipated to kick-off our project starting with district level sensitisation and advocacy meetings; but have not been able to do so because of the current political campaigns. All the targeted participants are busy struggling to make a comeback into leadership. Using our experience with local governments and advice from the TB focal person, we have agreed to undertake this activity in February –March 2011 when campaigns are over and with new leadership. This will give us the opportunity to engage the right people who will be in leadership for the next 5 years. This saves us from the burden and wastage of engaging leaders who could not make a comeback into the local government leadership.
-Need for immediate testing yet SDA does to have the capacity and means to do so in the community setting where social mobilisation activities do take place.
-Lack of a public address system; the project implementation team underestimated the attendance and participation during social mobilisation events; that have been normally backed up by week long radio announcements. It has been therefore a strenuous activity for the health worker and project team to pass on information to the crowds. This partly affected the participant attention span and good hearing especially among those with hearing impairments.
-The vastness of the project sub counties and the need expressed by local leaders to extend our mobilisation activities to 2 more sub counties than we had planned. This has only enabled us reach to “pockets” of worse-off deep rural communities where relapses and defaulting to TB treatment were report high by the district TB officer. Other communities have been left wanting.
-Weather has posed another challenge to community social mobilisation events; activities have taken place during the rainy season yet we did not plan for hall or tent hire; if even we had, our targeted rural areas did not have such facilities. Roads leading to venues have been sometimes impassable.
-Limited involvement of our staff in DOTs; we had planned to really entirely on local government health staff to undertake DOTs and home based car. We later learnt that the district did first of all not have enough staff cover all the project subcounties.Secondly did not have the transport means to move to various TB patients homes scattered all over the 4 sub counties.
Lessons learnt on data gathering and tracking of progress include;
-There is need to train health centre workers/laboratory staff in records management in order to enable them be able to avail up to date data. It is difficult for the health workers to track progress yet the number of people seeking for TB screening is increasing more especially after our intervention.
-The TB patients who are treatment need to be consistently followed up to ensure that they complete their dosage; persons tend to relax especially after a few months of taking the drug but later relapse.
-We also needed to use our staff/volunteers instead of relying on government health workers if we are to track progress and have data on progress; this we had not planned for it and thought that we would rely on health unit records to track progress.
-TB is still a big challenge especially among the rural illiterate poor who seem not even bothered for their lives. They are also ignorant of the available services and have a high apathy about claiming for their health rights. They feel that health workers are doing it as a favour to provide TB treatment services.
-The targeted Number of DOT under home based care will depend on how fast we detect further cases. This is because the project area had fewer people in need of TB DOT due to poor performance in detection.
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