20 Apr Independent TB Program Review: Zambia
[vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_separator type=”normal” thickness=”2″ up=”20″ down=”20″][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” angled_section=”no” text_align=”left” background_image_as_pattern=”without_pattern”][vc_column][vc_column_text]The Independent TB Program Review (IPR) took place in the Democratic Republic of Zambia 16th-29th February 2020. It was commissioned and led by the WHO Southern African Regional Office under the stewardship of its regional director, Dr Fabian Ndenzako.
The mission entailed a review of TB services in 10 provinces in Zambia. Each province team was led by an external reviewer and a local public health specialist to enable the team to better navigate the political landscape and possible bottlenecks.
The mission goal was to assess the effectiveness of the National Tuberculosis and Leprosy Program’s (NTLP) implementation of its National Strategic Plan in reaching the global targets under both the End TB Strategy and UN High Level Meeting on TB. The review further involved a critical assessment of the different components of the NTLP to inform the mission outcomes. To fully appreciate program gaps and implementation challenges, the teams were assigned two districts in each province and with four facilities to review in each district, using a set of tools which had been collectively revised and endorsed by both external and local experts.
The mission revealed some gaps under the NTLP which, if addressed, can see Zambia meeting its national and international targets. The NTLP needs to prioritize program interventions towards the strengthening of community systems. Advocacy, communication and social mobilization guidelines have not yet been developed despite national budget making provisions for it. Communities are not visible in the TB program as emphasis is more on clinical outcomes and less significance is placed on non-medical interventions.
The Stop TB Partnership Community, Rights and Gender Strategic Initiative facilitates the dialogue between communities, the government and development partners around needs on the ground and directing the TB response towards investing in priority areas relevant to their geographical setting. Also, it provides a paradigm shift to how decision making is affected, by focusing on the bottom-up approach as opposed to top-down, which often allows misalignment of programs and subsequent failure of interventions owing to the absence of community buy-in.
As a way forward, investment packages on human rights and community TB response should be integrated in Zambia’s funding request during the next Global Fund funding cycle. Community, Rights and Gender technical assistance should be sought for Zambia, to assist civil society organizations and communities in identifying priority issues and feed into the national strategic plan. Investment in community participation and human rights is a major priority.[/vc_column_text][/vc_column][/vc_row]