Overview

Afghanistan is one of the 22 high burden tuberculosis (TB) countries.  The incidence and prevalence of TB remains high; estimated incidence and prevalence for TB cases is 189 and 351 per 100,000 people, respectively, according to the 2012 World Health Organization (WHO) Global TB Report.  The Ministry of Public Health’s (MoPH) National Tuberculosis Program (NTP), with support from USAID and other donors, manages Afghanistan’s TB response.  USAID support through TB CARE1 in Afghanistan strengthens the managerial capacity of the NTP and expands access to Directly Observed Treatment Short-Course (DOTS) training for health workers.  The project focuses on ensuring universal access to TB services, including: DOTS expansion to public and private health facilities in Kabul and underserved and remote areas in 13 USAID-assisted provinces; TB infection control; health system strengthening; and, improving monitoring, evaluation and research. 

Activities

• Universal Access and Quality: Increases access to quality TB services in Kabul City and in 13 USAID-supported provinces.  Increases demand for and use of high quality TB services and improves client satisfaction with TB services.
• Implementation: Provides technical and financial support to the NTP for improved TB diagnosis and treatment by: conducting regular supervisory visits; providing on the job training for 400 health workers in TB DOTS learning centers in 13 USAID-supported provinces; and, training 120 female health workers in six other provinces.
• Infection Control: Supports implementation of TB infection control strategies and improves capacity for implementation of TB infection control measures in 13 provinces.
• Health System Strengthening: Assists the NTP in the implementation of the MoPH’s human resources strategic plan with respect to TB service delivery, ensuring that TB control is embedded as a priority within the national health strategies and plans.  Improves NTP leadership and management skills to sustain funding for the TB control program.
• Monitoring, Surveillance and Evaluation: Improves capacity of the NTP to generate quality data, and analyze and use such data to manage the TB program.

Accomplishments

• In 2012, identified more than 22,598 suspected TB cases, largely referred by community health workers.  2,821 patients tested positive and 4,397 are receiving DOTS from community health workers, an improvement in performance from 2011.
• Trained 1,666 health workers on TB detection and treatment and conducted first-ever training for 156 female health workers.
• Mobilized approximately 1 million individuals to celebrate World TB Day in 2012 and distributed more than 14,000 pamphlets and other TB education materials.
• Trained 154 NTP staff on leadership and organizational development.