End-term review of Nigeria’s National Strategic Plan for Tuberculosis Control 2015-2020

The Nigerian National Tuberculosis and Leprosy Program and World Health Organization Country Office hosted a meeting to review Nigeria’s National Strategic Plan for Tuberculosis Control 2015-2020. Teams investigated service delivery and human rights, and other challenges to service access in 12 of Nigeria’s state.

While Nigeria has made significant progress in delivering TB services through community, private sector and other interventions, some challenges remain in both accessing care and delivering testing and adequate recording and reporting. Additionally, grassroots organizations are not adequately funded; and the findings of the community, rights and gender assessment have not been disseminated.

The review noted that Nigeria’s First Lady and the State First Ladies are all engaged as TB ambassadors/champions and could further contribute to community buy in, in terms of early TB identification. Community-based organizations (CBOs) and civil society organizations (CSOs) were also identified as key contributors to case detection, advocacy, treatment support sputum transportation and contact tracing; and community contribution to TB case-finding has increased twice over the baseline.

It was decided that Nigeria should foster participatory community engagement with attention to key populations and socioeconomic barriers to accessing TB services by finalizing, disseminating and using  the reports for the community rights and gender assessment; addressing  key individual and social factors that influence care-seeking behaviours, including addressing stigma and empowering TB patients to demand service; strengthening the community TB system by increasing the number of community health workers, improving coverage of CBOs and providing operational running cost support.

It is important to deliberately engage community leaders, key population groups and organizations in TB decision-making responses; conduct CSO mappings to identify resources, opportunities and obstacles that may inhibit or enable active engagement; and include indicators to track patient perspectives and key socio-economic factors in the strategic plan (including catastrophic costs incurred by TB patients).

To support Nigeria in ensuring that the CRG findings and recommendations are prioritized in the new strategic plan, funding for implementation of activities will be sought through the Global Fund application and other platforms such as Local Organizations Network (LON), Challenge facility for Civil Society, TB Reach and Stop TB Partnerships (USAID).