Advocacy, Communication and Social Mobilization for TB Control in Kenya

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Advocacy, Communication and Social Mobilization
for TB Control in Kenya

• Chakaya J. M
• NLTP, Kenya.

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TB Disease in Kenya

• 2004
• 105, 747 of all types in 2004
• 41,467 New smear positive
• 41,220 New smear negative
• 14,949 New extra-pulmonary
• 8, 482 re-treatment cases
• TB CNR 320/100,000 for all TB
• 9-fold increase since early nineties
• Average annual increase 16
• CDR 50 of estimated incidence
• Estimated that over 60 HIV

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The key reasons for the TB epidemic in Kenya
HIV
and
Poverty
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TB Trends in Kenya 1990 - 2004
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TB Treatment outcomes 2003 cohorts (percentages)
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Constraints to TB control In Kenya

• A weak public health care system with inadequate
  health infrastructure including a low health
  facility density
• Inadequate Human resource for health
• Financing for TB remains inadequate and short
  term
• General knowledge of TB in the population is high
  but specific action oriented knowledge is low.

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The ACS Strategy

• The GOAL
• To use advocacy, communications and social
  mobilization to achieve the 70/85 TB control
  targets and to sustain this effort to eventually
  achieve the Millennium Development Goal 6
  target 8 ie To have halted by 2015 and began
  to reverse the incidence of TB in Kenya

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The ACS strategy

• The ACS objectives
• Advocate for development of supportive policies
  and increased funding for TB programs
• Increase awareness and knowledge of TB and reduce
  its associated stigma in the general public
• Mobilize the community and build its capacity to
  respond to the TB epidemic

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The ACS strategy in Kenya

• Multiple partners the ACS working group
• A variety of behavior change approaches
• Multiple audiences
• Needs assessment/evaluation of on-going
  programmes an essential first step
• Funding gap analysis

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Advocacy

• Target audiences include parliamentarians,
  ministry of health officials, the business
  community, religious leaders etc
• High light the growing TB problem and the
  socio-economic impact of TB to these decision
  makers
• Increase funding for TB control in Kenya
• Improve coordination of TB control activities.
• Impact assessment
• funding gap analysis
• and regular surveys of knowledge of TB among the
  decision makers in government, industry, trade
  unions etc
• Macro and Micro-economic impact surveys

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Communication

• The activities
• Mass media campaign
• IPC peer education, traditional folk media,
  non-conventional media in communities, schools
  and among health care workers
• IEC materials for mass pamphleteering
• Impact assessment
• Case detection and treatment outcomes
• KAP Surveys

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Communication

• Target audience
• General public
• School going youth
• Teachers
• Health care workers
• Journalists

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Social Mobilization

• Target audiences
• Religious leaders
• Civic and cultural institutions
• People at work sites
• Current and former TB patients
• People infected and affected by HIV
• Community based organizations

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The ACS strategy in Kenya

• An ambitious ACS strategy? Can it really be done?
• Who is going to do it?
• The capacity to do it.
• Will it be funded and if yes will the funding be
  sustained?
• If well implemented will we be able to meet the
  demand for services created by ACS activities?
• Impact assessment-Is this all?
• Examine funding gaps
• Inclusion of TB in key Poverty Reduction and
  Development papers
• In depth knowledge of TB among various groups
• Case notification and detection rate
• Treatment outcomes

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Overcoming the ACS challenges

• Request for Technical assistance
• Train and support ACS health care workers
• Increase number of players and sustain interest
  of these players in the ACS working group
• Hope for a successful intervention to increase
  funding and sustain funding as a result of
  advocacy activities.

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ACS

• Need sustained effort- ACS should be a long term
  affair
• Need long term financing
• Need a multiplicity of players
• Need to vary communication and social
  mobilization approaches to local context