Voices from the Field: Expansion Of HIV And TB Testing And Treatment

"I remember a big family of five who had just lost a mother to tuberculosis (TB), and we discovered that all four children were also infected by TB. I am glad we were able to save the children’s lives," says Esayas Leulekal, head nurse at a private clinic.

Since March of 2007, Leulekal has been working at Sama Senbet clinic, which offers free TB testing and medicine and is one of 149 private and workplace clinics and hospitals in the Oromiya and Addis Ababa regions launched by the Fenote Tesfa ("road of hope") project. IntraHealth International works on the clinical aspects of the project, led by Abt Associates, which has an ultimate goal of decreasing the incidence of TB and HIV/AIDS. The diseases rank high among the most pressing health concerns in Ethiopia, and to address them, the Ethiopian Ministry of Health has been providing training, drugs and laboratory supplies to public health facilities only. By enabling private health facilities and worksite clinics to offer affordable, high-quality TB and HIV/AIDS early diagnosis, prevention and treatment services, the five-year project gives more people access to much-needed care.

"We used to refer TB patients to Adama Hospital—around 25 kilometers from Modgo, where we are located," notes Leulekal. "The TB medicine requires strict follow-up: the first two months, a patient needs to come daily to the clinic, and for the remaining six months, they come once a month to collect their free medicine. Proximity matters."

Having a clinic onsite at a workplace is not only good for the employees but ultimately good for the company as well. “Previously, we diagnosed TB patients in the clinic and referred them to public health facilities for treatment . . . . But after the project started a TB/HIV program at our company . . . our employees are able to get TB treatment here onsite conveniently, and follow-up is easily conducted by health personnel from the clinic,” says Dr. Menelik Balcha, a company physician at Addis Ababa Abattoirs Enterprise. “This contributes to the decrease in defaulting of treatment, and . . . to the prevention of TB in the company. This will have an impact on the overall increase in productivity of the workers and profitability of the company.”

The project trains health care providers and equips private and workplace clinics to be able to offer services, including the World Health Organization’s recommended treatment strategy for detection and cure of TB as well as HIV counseling and testing, including mobile services. Fenote Tesfa has already improved the referral networks by developing partnerships between public and private sector health facilities and has developed a comprehensive TB/HIV referral directory.

In the last year and a half alone, Fenote Tesfa has served 6,160 clients in clinical services, including counseling, testing and/or TB treatment and trained 393 health providers and workers.

The project is funded by USAID through the President’s Emergency Plan for AIDS Relief (PEPFAR).

Project partners include: Abt Associates Inc., Population Services International, IntraHealth International, and Banyon Global. Important local companies and stakeholder organizations include Medical Association of Physicians Practicing in Private, Confederation of Ethiopian Trade Unions, and the Ministries of Health and Labor.