ACSM TA KENYA’S Experience
By
Jane Nyangara Onteri
Programme officer
Division of Leprosy, TB and Lung disease
ACSM at country level sub-group Working
Group Meeting
At
Southern Sun Hotel- Cape Town
5th -6th November 2007
Kenya
Background
Republic of Kenya covers an area 582,646 sq
kms
About 80% of its land is arid or semi-arid and is
sparsely populated
Population was projected to be 33, 829, 590
(est. 2005):
Life expectancy had dropped from 56.8 years in
1992 to 51 years in 2004 due to the AIDS
epidemic
GDP (2006 est.): $22.79 billion
Annual economic growth rate (2006): 6.1%
Gross national income per capita (2006): $455
Background cont.
 Kenya is ranked 10th among the world’s
22 countries with a high TB burden.
 Kenya’s TB burden and rates have
increased dramatically — a more than
tenfold increase from 10,000 in 1987 to
115,234 in 2006.
 Case notification rate increased from
110 per 100,000 population in 1987 to
325 per 100,000 in 2006
Background cont.
TB treatment success rate stands at
about 81% as of 2005
TB case detection rate of sputum smear
positive cases (SS+) has remained low,
at about 45% (WHO, 2007)
ACSM TASK Force.
 Formed in 2005
 Terms of reference are:
 To develop strategies for the
implementation of ACSM activities
 To promote multi-stakeholder
involvement in the implementation of
ACSM activities
ACSM Task Force TORs Cont.
To develop suitable health care worker
training programs, training
manuals/guides and other materials to
promote best practices in the
implementation of ACSM activities
To develop suitable indicators for
monitoring and evaluation of ACSM
activities
To hold quarterly ACSM review
meetings
The ACSM TASK Force Cont- TASK Force Membership
 DLTLD-Focal persons for ACSM (MOH)
 DLTLD-Focal person for CB-DOTS (MOH)
 PATH (Partner)
 FHI (Partner)
 AMREF (Partner)
 NASCOP (MOH)
 PSI (Partner)
 NEPHAK (Partner)
 Division of Environmental Health (MOH)
 Division of Health promotion (MOH)
TA for ACSM
For formation of Task force
Development of R5 GFATM
Development of advocacy and
communication strategy documents
Development of overall TB strategic plan
2006-2010.
Development of TB M&E framework
Tools developed for ACSM
 National TB/HIV Communication strategy was
developed and launched (Lights of Hope)
 DLTLD National strategic plan -2006 to 2010
developed (issues on ACSM addressed)
 Monitoring and Evaluation framework for DLTLD
has been developed (ACSM Addressed)
 Development of the National Advocacy Strategy to
Fight TB/HIV is in progress (draft is available)
 TB community sensitization guide for community,
business and religious leaders (Draft available)
National Communication strategy
The communication
strategy was developed
and launched March
2007 (Lights of Hope)
It addresses issues of
symptoms, diagnosis and
treatment and communication
channels
National Advocacy strategy
National Strategy
to Fight TB/HIV
draft is available
It address issues of
policy,
stakeholders/developm
ent partners,
TB/HIV collaboration
human resource and
logistics
Funding
ACSM is funded by GFATM round 5
The main objectives in the Round five
proposal were:
To advocate for development of
supportive policies and increased
funding for TB programs
To increase awareness and knowledge
on TB and reduce its associated
stigma in the general public and
people with TB/HIV
Funding cont.
To mobilise the community and build
its capacity to respond to the TB
epidemic
To monitor and evaluate ACSM
Activities
Apart from Global fund and GOK, the
program also receive funds from CDC
and WHO for ACSM activities
ACSM Achievements
 Advocacy
TB/HIV advocacy strategy draft is in progress
A task force on ACSM formed, functioning and meets
on quarterly basis
 Communication
TB/HIV communication strategy has been developed
and disseminated
Mass media campaign on going
Magnet theatre trainings going on –Over 600
persons trained on TB/HIV
Quarterly newspaper advertisement done and on
going
Production of IEC materials- Posters, Brochures, Tshirts, pamphlets, leaflets, flyers, stickers, spin wheels
Achievements cont.
 Social Mobilization
Public health Officers sensitized on ACSM- 73 /80
districts(91.25%)
Civic and religious leaders sensitized in 32/80
districts(40%)
Training and retaining of TB ambassadors on going
 Peer to peer education at workplace on goingabout 599 persons from different companies trained
on TB/HIV
Survey on private DOTs providers offering low cost
TB services and those willing to do so on going
Specific Activities
1.Mass Media campaign 2007
TV - Citizen, KTN, NTV between 8pm - 9pm
Makutano Junction a TV 30 minutes program
supported by CDC on going.
Radio spots- Citizen, Easy, Ramogi, Inooro,
Kameme, Simba and Mulembe. Time: between
6am - 9am and 4pm - 7pm
Radio 30 minutes call in show – 12 shows done
with 12 TB/HIV topics
Print – Nation, Taifa leo and Standard
Newspapers
Mass media campaign cont.
Media July
spots
August
spots
October/Nov Total of
. spots
spots
Print
6
9
20
Radio 103
365
12
480
TV
10
0
26
5
16
Total
515
New paper adverts
Newspaper adverts cont.
Newspaper advert
2. IEC Materials produced
3. T-shirts
Monitoring and Evaluation
Campaign placement is being monitored
through Steadman’s media monitoring
service, to ensure that commercials are aired
correctly and according to schedule
Support supervision is being offered to the
districts and the provinces on ACSM
A survey will be carried out on the impact of
ASCM activities soon
Challenges
 How to increase case detection and treatment
success rates
 Reduction of defaulter rates and out of controls
 Prevention of emerging MDR-TB
 How to motivate and increase staff morale
 How to integrate TB services with other public health
services
 How to build a cohesive provincial and District teams
 How to reduce TB/HIV stigma
 Human resource issues such as shortages and
training
Conclusion
TB progam in Kenya is well managed,
working and with continued support that
we are currently receiving, we envisage
significant reduction of TB cases and hope
to reverse the trends
Let us join hands together and
fight TB
THANKS