CPAR Uganda Ltd

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Empirical Qualitative Data on TB in Uganda

CPAR Uganda Ltd (CPAR) is satisfied that it has successfully implemented its role as part of the Tuberculosis: Working to Empower the Nations’ Diagnostic Efforts (TWENDE) Consortium. TWENDE was an EDCTP funded research and policy advocacy project which was implemented from January 2016 to December 2017 in the three East African Countries of Uganda, Kenya and Tanzania.

In Uganda, CPAR was responsible for conducting a high impact TWENDE qualitative investigation that uncovers and addresses the impediments for implementation of health research innovations; explores the attitude of health care staff and administrators to funding of tuberculosis (TB) medical tests; unravel the impediments to wider uptake of effective TB diagnostics; engage policy makers; and explore reasons why in places TB assays are unavailable.

Read more: Empirical Qualitative Data on TB in Uganda

Obsolete TB Diagnostic Machines Miss 60% of Cases in Uganda

Ugandans travel long distances seeking tuberculosis (TB) diagnostic services because most of the lower level health facilities – health centre Is, health centre IIs and health centre IIIs – are equipped, if at all, with obsolete light microscopes used to diagnose PTB by the smear microscopy technique.

The first Uganda national TB Survey that was conducted by Ministry of Health in 2015, moreover, found that “smear microscopy, the main TB diagnostic test in the country, misses about 60% of the cases”; a finding which led the Ministry of Health to conclude that there is a “need to update the country’s TB screening and diagnostic algorithms.”

Read more: Obsolete TB Diagnostic Machines Miss 60% of Cases in Uganda

Under Financing TB Healthcare in Uganda 2013 to 2017

Uganda’s first national tuberculosis (TB) survey which was conducted by the Ministry of Health in 2015 estimates that Uganda has 87,000 TB cases annually; an annual prevalence rate of 253/100,000; and a rate that is higher than had previously been thought.

High level Government of Uganda officials, such as the Minister of Health, Hon. Dr. Jane Ruth Aceng, moreover,  acknowledge that Uganda’s “TB burden has continued to cause an enormous health challenge to the people of Uganda and is a big public health challenge to the health system in Uganda. Additionally, TB presents an economic challenge and impacts negatively on the livelihood of our people.” It is therefore baffling that Uganda national budgets for TB management are consistently underfunded.

Read more: Under Financing TB Healthcare in Uganda 2013 to 2017

Plight of TB Patients in Uganda

The situation of tuberculosis (TB) patients in Uganda “has changed a lot because we now have drugs or oral tablets administered for treating TB for 6-8 months depending. TB is curable and thanks to that. I took TB treatment for six months and got well,” wrote Acheng Tabitha in response to the question: “This was over 25 years ago, but has the situation changed at all – for good or for bad?” which was posted on social media together with a testimony of a TB survivor from 25 years ago.

Read more: Plight of TB Patients in Uganda

Take TB seriously

Let me start by welcoming all of you from different districts to our district here of Gulu (applause). You are most welcome. Since we are actually concluding this meeting early enough, I still invite you to remain and to look around the beauty of Gulu District.

I am very happy that we have done commendable work from morning to now. What we have done here is really quality and great work. I want to thank all of you very, very much.

This is a workshop where I observed that people did not move out. I always go for meetings like this, people move out. You find that may be we started with 30 people, by the time of winding up there would be only 15 or so. But here we remained and we were committed (applause). Everybody was committed. I wish we can always remain committed in whatever we do, the way we have been committed here. I must thank you very much.

Read more: Take TB seriously

Talk TB in the Budget

When we were starting these policy workshops, I told you that these workshops are different. They are different because they are unusual, because even the doctors do not discuss these issues they way that they have discussed them here, in an open way.  

If something is bad, say it is bad. You were invited for these workshops and we said we are going to discuss with these leaders openly; we are going to use the Chatham House Rule, where we want to be honest, talk openly, because nobody will be quoted individually.

Read more: Talk TB in the Budget

Fight against TB to Parliament

Our honourable chief guest, chair, ladies and gentlemen, the feedback on the state of tuberculosis (TB) in Uganda that we have just received has been quite insightful.

Starting with the technical team, they had a very rich discussion. They probed into the issues that we need to pay attention to. I think that they have identified, in various ways, the things that need to be paid attention to.

The administrators came out straight forward with issues around the financing of TB services. They were straight to the point. They were focused in what they had to recommend. They talked like administrators, “this is what we recommend.” They were fearless.

Read more: Fight against TB to Parliament

War on Tuberculosis in Uganda

Tuberculosis: Working to Empower The Nations’ Diagnostic Efforts (TWENDE) is a research and advocacy project which is convinced of the theory of change that is based on the assumption that empirical data can be collected; and which data documents the barriers that hinder up-take of successful tuberculosis (TB) diagnostics and also the opportunities that can accelerate up-take of successful TB diagnostics.

The theory’s logic follows that TWENDE can collect empirical data and that once collected, documented and analysed, the data can be a sound basis on which to engage policy. Engaging policy, within the context of TWENDE, is with the view of influencing policy makers and implementers, in a conciliatory manner, in order to encourage the translation of research innovations into policy and into practice; and thus improving access to TB diagnostics and medication.

Read more: War on Tuberculosis in Uganda

Citizen Story of a TB Survivor

 

Twenty five years ago, I woke up early in the morning, around 05:00 a.m. and I went to the spring well to fetch water. It is good to fetch drinking water very early in the morning. As I tried to draw water from the well, I slid and fell into the well. I stayed in the water for a long while and I lost consciousness before I was rescued. About three years after I fell in the well, I started to experience chest pains and I began to cough. I received treatment for chest pains and for cough, but the pains and cough persisted.

Shortly after, my husband passed away; and moreover he passed away during the hunger season. I had no help. I decided to return home to my parents. I came home together with my young children – three girls; my only son died as a baby. My parents allocated to me a plot of land on which I have built my home. I have built two grass thatched huts at my homestead – one is where we sleep and the other is a kitchen and store.

Read more: Citizen Story of a TB Survivor

“We will #endTB!” Moscow Declaration

 

Tuberculosis: Working to Empower the Nation’s Diagnostic Efforts (TWENDE) is a research and advocacy project which is convinced of the theory of change that is based on the assumption that empirical data can be collected; and which data documents the barriers that hinder up-take of successful tuberculosis (TB) diagnostics and also the opportunities that can accelerate up-take of successful TB diagnostics. The theory’s logic follows that TWENDE can collect empirical data and that once collected, documented and analysed, the data can be a sound basis on which to engage policy.

Engaging policy, within the context of TWENDE, is with the view of influencing policy makers and implementers, in a conciliatory manner, in order to encourage the translation of research innovations into policy and into practice; and thus improving access to TB diagnostics and medication.

Read more: “We will #endTB!” Moscow Declaration