Digital Platform to facilitate Community Based Monitoring for TB response in Tanzania
Community-based monitoring Engaging TB patients and the affected communities to report the barriers they experience, to strengthen the TB M&E system, improve the responsiveness, equity and quality of TB services and hold TB service providers to account. (Global Fund, STP , DRC) 04 TB & Human Rights • Person and affected communities placed at the center as equal partners TB & Human Global Plan to Investing to End TB Rights Briefing End TB End Epidemics Strategy Note Alignment Al K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Problem Statement In Tanzania there is no systematic or real time (timely) data collection of barriers that prevent people from accessing TB services and completing TB treatment (i.e. the missing people with TB ) As a result Ø Care and Support Responses that address the barriers to access are late (e.g. drug stock outs, which can lead to treatment interruptions even Ø death) Ø Monitoring, Surveillance, Advocacy and Engagement Community advocacy is not evidence based Ø Evaluating services is difficult due to the absence of data Ø Limited engagement and feedback mechanism between CS/CG/TB-Patients and key decision making platforms (NTLP, TNCM, Ø MoH, TAMISEMI) Ø Programmatic Management of TB Planning is uninformed and does not respond the problems faced by those vulnerable to, at risk of and with TB Ø Ø It is difficult to justify a multi-sectoral approach, that links people to appropriate services K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
OneImpact CBM Intervention Objectives K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
OneImpact App – empowering people with information about TB, with ways to connect to a community and to report problems within an accountability framework K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Stop TB Partnership OneImpact Digital Platform to facilitate CBM Community Health Worker Inbox Multi-stakeholder Accountability Dashboard Patient APP K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
OneImpact CBM Accountability Framework Surveillance, Programmatic Monitoring, Surveillance, Response Care and Support Services for People with TB Advocacy TB Patients Health MKUTA/ NTLP/ MKUTA / CTT Services TNCM /TAMISEMI CS/CG supported by Constituency EANNASO National TB Program and the Tanzania National Coordinating Lead CBO/Country Task CHWs Respond – link patients Mechanisms Team monitors & reports People Report to relevant services to ensure surveil and use data barriers to access (for Problems treatment adherence for programmatic decisions advocacy) K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Innovation and Strategies CRG Strategies Digital Solutions Community-led advocacy to obtain buy-in Interconnected digital solutions from NTP and other strategic partners (e.g 1. Patient App (free) TNCM) who; 2. Community Health Worker Inbox ◉ Endorse, approve and support the pilot 3. Accountability Dashboard and scale-up of the intervention (Global Implementation Science Approach Fund, USAID, WHO, CORDAID, Global EGPAF, Stop TB DRC, UCOP+, LNAC, Learning as we go Fondation Femme Plus) Generates strategic information to inform human rights and gender responses to TB K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Implementation Targets Site ◉ Usability (patient care) ○ 100% active App users ◉ Kigoma Ujiji (District) ○ 85% of active App users satisfied with the App ◉ 8 health centres /hospitals to be engaged ◉ Efficiency (patient care) (Bangwe, Baptist, Buhanda, Gungu, Maweni ○ 85% community response implemented within 72 hours Hosp, Rusimbi, S.D.A, Ujiji) ○ 85% of active App users satisfied with the response ◉ Programmatic (monitoring, surveillance, advocacy) ◉ Target 122 of patients ○ 1 report / month with information on drug stock outs, stigma, ◉ 17 CHWs engaged and to be trained treatment interruptions, accessibility and quality of services ◉ M&E ◉ Partners involved (NTLP, MKUTA, TAMISEMI, ○ Report on feasibility of using the App, its usability, acceptability, TNCM, CTT, TTCF, EANNASO) scalability and any resulting social change documented. K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Programmatic indicators to be monitored • Drug stock out ◉ Barriers reported Immediate • Side effects response ◉ Frequency of occurrences • Stigma Long term data for ◉ Location of occurrences programmatic • Access to TB services ◉ Time of occurrences action • Quality of services • Treatment interruption • Out of pocket expenses • other K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Implementation ◉ Conducted community stakeholder workshop and developed content with the communities. ◉ Developed the dashboards for data collection, reporting and training materials ◉ Approval from relevant government authorities § MoH § Local Government Authority (TAMISEMI) K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
Implementation Science Implementation Phases* *Follows the WHO Handbook on Digital Technologies for TB Aligns with End TB Strategy, Global Plan to End TB, STP TB and Human Rights Information Brief K I K U U A U N F A K I U A K Y I M O W N A I B T M A N A Z P A A M N I * A *
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