Involvement of community-based
organizations in the fight against
Tuberculosis and TB/VIH co-infection in
Burkina Faso
Dr Fodé SIMAGA
[email protected]
Cancun 2009
Contents
Introduction
I.
II.
III.
IV.
History of the project
implementation
The community response strategy
Program Structure
Challenges and Perspective
Conclusion
INTRODUCTION


Burkina Faso Round 4 Global Fund
grant implementation: NTP and
PAMAC partnership
In
terms
of
community/CBO
mobilization, the national context
made it possible to implement a
country-wide
CBO
involvement
strategy
What is PAMAC?

Support Program to Communitybased Organizations:
National Programme funded by
different Partners to support
community-based organizations
involved in the fight against HIV,
Malaria and Tuberculosis.
What is PAMAC?

PAMAC's role :
- Build community-based
organizations' technical and financial
capacity.
- Empower them to deliver quality
services complementing the health
system
- Empower them to become
recognised actors.
I. History of the project
implementation (1)
Since 2005, PAMAC is chosen as SR
for the community response for GF
round 4 TB
It is about:
- implementing the community
response of the National TB
Programme;

I. History of project
implementation (2)
- elaborating a community/CBO
response implementation strategy
respecting the demands of all
actors,
- organizing and coordinating
community actions,
- Build their capacity in a sustainable
way
II. Key point of the community response
strategy (1)

A response-design with a
participative approach
Taking into account health
professionnals, community actors
Strategy baseline



National intervention taking into
account urban and rural specificities;
Emphasis on vulnerable populations
through
patient-based
and
community activities;
Functional country-wide M&E and
supervision
system
for
CBO
involvement
Key principles
Model of CBO involvement designed
around following key interventions:
- sensitization
- community support services
- a referral of TB symtomatics to the
health center
Complementarity and synergy between
community and health institutions
with actions at national and regional
levels

NTP
Sensitization: 11
regional networks
Treatment support:
1 regional network
CBOs
(sensitization,
referrals)
PLWHA org's
(sensitization,
referrals)
Traditional healers
(referrals)
District
Health
Center
TB pts orgs
(support,
referrals)
Urban treatment
support Org's (home
visits, defaulter
retreival, referrals)
III- Programme structure
The actors
 11 Regional coordinating
networks: «structures pivot»
- Role:
-
coordination,
technical support,
financial support
III- Program structure
CBOs involved in sensitization
- Theatre
- Cinema and debates
- Community sensitization dialogues
! During these activities TB symptomatics
will be referred to the health centers
(referral sheets developed).
 Quarterly supervision by Regional
Network

Community sensitization activity
using flip chart
III- Program structure
CBOs involved in community
support
- permanent presence in the TB Tx/Dx
centers
- Support to patients with adherenceto-treatment-related challenges
- home visits (with contact
investigation and referral of
symptomatics)

Psychological support to a patient
III- Program structure
Traditional healers' Associations
Suspected case referral to the health
centers.
 Patients Associations
advocacy activities in the community.
 PLWHA Associations
In charge of controling the HIV-Tb coinfection.

Results 1



From October 2005 to march 2009:
3 597 community actors trained
in Tuberculosis prevention and care
28 322 prevention activities
conducted in which (50% of
activities supervised by health staff)
Results 2




More of 1 777 572 persons
sensitized
7534 Tb patients benefited from
one form of treatment support
activity
10433 home visits realized
12162 suspected cases referred
from which 873 tested positive
Challenges and perspectives 1


The sustainability of community
mobilization with adequate financial
resources;
Satisfying structure of CBO
involvement, but varying level of
expertise in CBOs;
Challenges and perspectives 2

A real integrated approach of HIV and
Tb control
TB/VIH coinfection
Further increase in contribution to sm+
case detection needed
Principal
challenge of the national strategy
(n.b. Challenges with estimated CDR [less
than 20%] – most probably a grossunderstimate – prevalence survey
planned in 2010)

Challenges and perspectives 3
Global Fund Round 8 TB:
- Starting probably in January 2010
- PAMAC is becoming PR
new
challenges.
CONCLUSION


An organized and structured CBO netowork
is able to respond to the challenges of
fighting against Tb
The round 8 will ensure continuity of
activities. It will build on the success and
experiences of 5-year implementation and
address observed weaknesses (primarily to
respond to the principal NTP challenge:
increasing case detection).