In the week of 18th February, a cross-party UK parliamentary delegation went to Ethiopia to explore how the country is dealing with key health issues. Sir Tony Cunningham MP, Heather Wheeler MP, Kevin Barron MP, Baroness Hooper and Lord Hussain visited the TB REACH project in Awassa, Southern Ethiopia to understand how it works and its impact.
Funded by the WHO’s Stop TB Partnership, the objective of the TB REACH project is to promote early and increased case detection of tuberculosis (TB) cases and ensure their timely treatment, while maintaining high cure rates within TB programmes at national level. TB REACH focuses on using ground-breaking approaches and activities in reaching people who are poor, vulnerable or have limited access to TB services. This collaborative implementation project was conceived by Dr. Mohammed Yassin (Global Fund to Fight AIDS, Tuberculosis and Malaria and honorary research fellow at LSTM) who designed it with Dr. Daniel Datiko (TB REACH project, Ethiopia/LSTM), Prof Luis Cuevas (LSTM) and Dr. Sally Theobald (LSTM). The project is managed in Ethiopia by Field Director Dr. Daniel Datiko and team.
The project uses a community-based approach that has engaged locally deployed female Health Extension Workers (HEWs). The HEWs are employees of the Ministry of Health, live in the villages where they work, and are thus part of and accepted by the community and familiar with the local culture. In the first year of the project HEWs working in 524 kebeles (local areas) and over 300 staff from health facilities were trained. Individuals with TB symptoms were identified by HEWs through house-to-house visits and outreach activities. HEWs collect sputum, prepare smears and liaise with supervisors using mobile phones. One supervisor with a motorbike is deployed in each of the districts to collect and submit slides to laboratories and feedback results, initiate treatment for smear-positive cases in their residence and screen contacts. In the current year 2 of the project, the diagnostic process is being further strengthened through the introduction of the LED Fluorescent microscopes and automated nucleic acid test (Xpert® MTB/RIF) for smear-negative patients with a high risk of having active TB (such as HIV co-infected individuals and children). The innovative community-based approach is supported by key stakeholders in the region; it brings services closer to communities and in year 1 smear-positive case notification almost doubled.
Dr. Datiko hosted the visitors taking them to visit the Sidama Zone Health Department, district offices, health posts (where HEWs are based) and communities. Dr. Datiko commented that the parliamentary delegation were especially impressed with the project’s integration within the health system, its innovation to improve access and the special focus on the poor, women and people with disabilities.