TB CAP Program Boosts Service Provision in Ethiopia

Ayele Fikre is a lab technician at Adama Health Center in Ethiopia. He is very enthusiastic when he talks about the changes that the U.S. Agency for International Development (USAID)-supported program, Tuberculosis Control Assistance Program (TB CAP), has brought to the way his lab has been performing for over a year.

Previously, Fikre had training about tuberculosis (TB) along with topics such as HIV and malaria. However, his knowledge was improved after he took part in a-five-day External Quality Assurance TB training provided by TB CAP through Management Sciences for Health (MSH). The program included AFB Microscopy training, supervision training, and stressed the importance reliable testing. 

“The training enabled us to be concerned about quality. Before, our reporting standards were very low and we even used to throw away some slides,” he said. “Now all slides are kept and submitted for external quality supervision.”

After the five-day training, Fikre is equipped with an in-depth knowledge of TB. His lab now has a standard operating procedures and a good documentation system. TB CAP provided the health center with a new and functional microscope, now the TB causative organism is easily identified which helped the lab to improve its detection of the smear positive rate from 7.9 in 2008 to 13.34 currently.  

The program support includes training on various lab equipment and logistics. As Fikre explained, they now use a standard reporting system with a log book provided by TB CAP. The lab also started undertaking an internal quality control of their reagents which was not tracked in the past. This became possible because the TB CAP program trained the laboratory staff and identified gaps in equipment. To make the system sustainable, quarterly and uninterrupted joint supervision is undertaken by the program staff, consultants, and regional and zonal staff of the National Tuberculosis Program.

The training program boosts the confidence of the staff, and promotes better provision of services to patients. Fikre said, “In the training, we thought about the techniques of sample collection, safety, and ways of smearing in order to come up with accurate results. If we can correctly diagnose TB, and if treatment is given [in a timely manner], we can control this disease in our country and that is what TB CAP is accomplishing. For me, TB CAP is results oriented and efficient. USAID has made a big impact in our zone in the fight against TB.”

MSH is a collaborating partner on the USAID funded TB CAP project in Ethiopia. MSH is working to improve diagnostic capacity for TB and TB/HIV, improve clinical diagnosis of TB, strengthen TB/HIV collaborative activities, and improve the TB drug management system.