Detailed Mechanism Funding and Narrative

Years of mechanism: 2010 2011 2012 2013 2014 2015 2016 2017 2018

Details for Mechanism ID: 10397
Country/Region: Namibia
Year: 2013
Main Partner: KNCV Tuberculosis Foundation
Main Partner Program: NA
Organizational Type: NGO
Funding Agency: USAID
Total Funding: $243,010

Through the Royal Netherland Tuberculosis Association (KNCV), TB Care I provides technical support to the National TB and Leprosy Control Program (NTLP) to strengthen its capacity to address the TB/HIV burden in Namibia. The project goals are to accelerate early TB case detection and treatment success rates to achieve national targets of 70% and 87% respectively. The implementing mechanism (IM) supports the expansion of community TB care; prevention and treatment of drug-resistant TB; scale-up of TB/HIV collaborative activities and health system strengthening.

KNCV promotes sustainability and builds capacity of local staff in order to phase out external technical advisors. The IM improves cost-efficiency by using a TA model rather than service delivery. The IM co-locates project staff with the MOHSS; provides supervision and mentoring; and supports existing government structures for TB/HIV care.

KNCV collaborates closely with the Global Fund to ensure technical and financial assistance to NTLP is optimally organized. The IM is also engaged in the quarterly TB National Steering Committee meetings at which key stakeholders map national TA needs.

In addition to being in line with the NTLP strategic plan, the IM supports USAID Namibias GHI strategy to: 1) Increase access to services; and 2) Help transition inherent government responsibilities, including funding for the community activities.

TB CARE I has an extensive monitoring and evaluation system to track the implementation of activities. KNCV does not operate separate M&E systems, but contributes towards strengthening the existing system. As a result, NTLP has been able to produce comprehensive annual reports for the past four years reflecting all its achievements.

No vehicle purchases are envisaged.

Funding for Care: TB/HIV (HVTB): $243,010

USG support will continue through KNCV TB Foundation using a TA model of knowledge and capacity transfer. KNCV support to the MOHSS and CSO is coordinated by the MOHSS National TB and Leprosy Program. Identifications of priority areas for support are aligned with the national strategic plans for TB and HIV. In line with the GHI strategy, KNCV does not support human resources for service-delivery to conduct TB activities. The NTLP is being prepared for gradual transition of current resident technical advisors.

TB/HIV care and treatment: In FY13, KNCV will continue to strengthen the implementation of TB/HIV collaborative activities with particular focus on the 3 Is. KNCV will support the MOHSS and its partners to improve early identification of TB in HIV infected individuals using the five question screening tool. TB screening will be expanded to ante-natal clinics (ANC) in addition to the pre-ART clinics to eliminate missed opportunities. The USG HIVQUAL program will be critical to this intervention. Intensified case-finding strategies will include the community to address gender inequalities for children and women in particular.

Provider-initiated counseling and testing (PICT) for HIV in TB patients remains a focus area and KNCV will increase HIV testing in TB patients currently at 76%. Given the low coverage of ART in TB patients early initiation of ART in line with the revised national guidelines will be key focus area under this component. KNCV will engage local care providers to develop the best modalities for the implementation of IPT given the high Isoniazid resistance rate. KNCV will also provide support to operational research on aspects related to TB/HIV.

Programmatic management of drug resistant TB (PMDT): KNCV will continue to strengthen the implementation of the PMDT in the designated treatment centers. Early TB diagnosis using the standard diagnostic tools as well as rapid molecular diagnosis for drug resistant (DR) TB will be promoted and implemented in high burden areas for both HIV and Multi Drug resistant TB. KNCV will continue to support the MOHSS with its efforts to reduce Extreme Drug Resistant TB. KNCV will continue to support quarterly review meetings to strengthen surveillance of DR TB and to update the monitoring tools.

Health system strengthening: Health care workers will be trained on the revised TB guidelines. KNCV will also support the MOHSS to strengthen TB/HIV coordination in poor performing regions through tailor-made support. KNCV will continue its mentoring activities to MOHSS officials coordinating TB/HIV activities at the national and regional level to strengthen their capacity to support the implementation level. Limited support will be provided to national and regional level NTCP staff to enhance their program management capacity and skills.

TB Care and Treatment: KNCV will continue its support to community TB care in the Erongo and Karas regions respectively. Support will also contribute towards activities for the commemoration of the World TB day. Under this component USG support will contribute towards the lifestyle ambassadors quarterly meetings for the TB Communication for Behavior Change Intervention (COMBI). Training of field promoters will also be supported under this activity. KNCV will support surveillance and monitoring activities related to TB care and treatment, including CSO.

Key Issues Identified in Mechanism
Increase gender equity in HIV prevention, care, treatment and support
Child Survival Activities
Military Populations
Mobile Populations
Tuberculosis
Workplace Programs