THIS IS AN ONGOING ACTIVITY. THE NARRATIVE IS UNCHANGED EXCEPT FOR UPDATED

REFERENCES TO TARGETS AND BUDGETS.

The only changes to the program since approval in the 2007 COP are

+ Prime partner PATH has been competitively selected to implement the activity thru a Washington issued

task order named "TB Task Order 2 (PATH)" a change from the previous mechanism TASC 2 TB.

+Geographic coverage has been revised (or expanded) to include 15 additional districts to make a total of

30 PATH supported districts on TB/HIV activities.

+ PATH will focus a lot more on training, technical assistance and supportive supervision to the Assistant

District TB and Leprosy Coordinators (ADTLCs) who support TB and HIV collaborative services at the

district level moving away from salary support for this workers. The salary support is anticipated to come

through the Capacity Project.

(Since PATH works in areas already covered by APHIAs who are reporting on TB/HIV activities the number

of persons treated will not be reported by PATH to minimize the risk of double-counting).

1.LIST OF RELATED ACTIVITIES

This activity is related to activity #7001 in the TB/HIV program area.

2.ACTIVITY DESCRIPTION

The Program for Appropriate Technology in Health [PATH] is a non-profit organization working in close

collaboration with the National Leprosy and TB Program [NLTP] of the Government of Kenya to scale up

TB/HIV collaborative activities to increase detection, care, and treatment of HIV-infected individuals by

increasing the number of people with TB who are tested for HIV and linked to care. PATH partners with the

NLTP, KAPTLD, KNCV and WHO in the implementation of these activities. In the year 2005-2006, PATH

supported Assistant DTLCs in 10 priority districts to implement TB/HIV collaborative activities. The districts

PATH currently supports include Kwale, Kilifi, Mombasa, Nyeri, Kiambu, Thika, Nakuru, Kericho, Nandi

South and Uasin Gishu. PATH has also facilitated joint TB/HIV planning workshops in Rift Valley and Coast

Provinces involving DTLCs, Assistant DTLCs, DASCOs, PMLTs, PASCOs and PTLCs, with another

planned for Central Province. The activities PATH will undertake in the FY 2007 COP period include

strengthening the human resource capacity by training health providers from both public and private

institutions in TB/HIV collaborative activities hence expanding these services to more outlets. PATH will

facilitate the orientation of health workers in ACSM strategy so that they can be adequately involved in

sourcing for more support and resources towards reducing the burden of TB in HIV patients. PATH will also

facilitate Nairobi University and Medical Training College [MTC] to set up or strengthen the existing

resource centers to provide greater accessibility to reference materials on TB/HIV for stakeholders. PATH

will support 15 additional Assistant DTLC to cover a total of 30 PATH-supported districts in the year 2007-

2008, to be posted to areas that will be decided on in collaboration with NLTP. PATH will scale up TB/HIV

integrated activities in the 30 priority districts, increasing the number of TB patients receiving DTC for HIV

and initiating care. Routine monitoring and evaluation of TB/HIV management in the supported districts will

be strengthened by PATH in close collaboration with NLTP and other stakeholders by supporting the use of

supervisory and on-job mentoring, setting up email and fax system at the provincial and district level so that

standardized and quality supervision with technical assistance is realized at all levels with timely delivering

of data to the right stakeholders. PATH will expand collaborative services through outreach to pharmacies,

private clinics and other health providers, facilitating monthly supervision and TB/HIV collaborative meetings

at different levels so that there is increased number of referrals to facilities with TB and HIV testing and

care, giving regular technical assistance to all facilities, documenting lessons learned and correcting slow

progress. PATH will stimulate community level demand for HIV testing and TB diagnosis in the 30 priority

districts and nationally by facilitating the development of job aids to be used by health workers both in

private and public institutions to scale-up awareness on TB/HIV co-infection. The existing magnet theatres

will be strengthened in addition to the development of radio spots. PATH will also facilitate peer education

on TB/HIV co-infection in these districts. All these will lead to improved knowledge of the community on the

two diseases resulting in the increase of care seeking behavior and referral of TB and HIV to care giving

centers. PATH will facilitate the printing and distribution of surveillance and monitoring tools, directories and

technical guidelines so that TB/HIV Coordinators are well equipped to engage facilities in data management

and referral of TB and HIV patients. PATH in collaboration with NLTP will strengthen the laboratories and

improve the general quality of TB/HIV diagnostic capability in both private and public institutions by

training/updating these providers on diagnostic skills, facilitating the PMLTS and DMLTS to carry out on-site

visits and technical assistance to the laboratory personnel, strengthening the co-operation and coordination

between laboratory, NLTP and NASCOP; and procurement and replacement of microscope and microscope

parts based on the existing scheme or guidelines. By September 2008, PATH estimates that as a result of

PATH efforts, 10,000 HIV-infected people attending HIV care/treatment services will receive treatment for

TB disease, and 10,000 HIV-infected people will receive TB preventive therapy. Number of individuals

trained to provide clinical prophylaxis and/or treatment for TB to HIV infected individuals will be 500, and

number of outlets providing clinical prophylaxis and/or treatment for TB for HIV- infected individuals will be

60.The main populations being targeted here are people living with HIV/AIDS and Health workers.

3.CONTRIBUTIONS TO OVERALL PROGRAM AREA

These activities will result in 10,000 HIV/TB co-infected persons receiving care in TB and HIV care settings.

4.POPULATIONS TARGETTED

Populations targeted are persons living with HIV/AIDS that are also co-infected with TB, and health care

workers.

5.LINKS TO OTHER ACTIVITIES

PATH's activity in TB/HIV is directly related to NLTP's efforts in this same program area.

6.KEY LEGISLATIVE ISSUES

This activity addresses stigma and discrimination in the training setting.

7.EMPHASIS AREAS

The major emphasis area is training with a minor emphasis in human resources.