Technical support boosts TB care strategy in SA

The Gates Foundation has awarded Genesis a grant to provide technical support to the National Department of Health as part of the foundation’s $2.5-million, three-year tuberculosis (TB) delivery strategy for South Africa.

This is the second phase of the programme, which was launched in 2021. It will focus on supporting the implementation and scaling of evidence-based interventions to reduce gaps in TB care cascades.

Through this grant, a TB technical support unit (TSU) was embedded in the National TB Programme (NTP). Overall, the programme aims to fast-track the effective implementation of the TB Recovery Plan and National TB Strategic Plan across all nine provinces. Through evidence-based strategies, we provide targeted support across multiple levels of the health system:

• Strengthening the meso-level (districts and subdistricts)) for sustainable quality improvement: In Gauteng’s Sedibeng district, we empower facility managers, district managers and health workers through quality improvement masterclasses. These workshops offer actionable insights to address challenges such as loss-to-follow-up in TB treatment. In addition, we are spearheading the development of TB focal points in the province by creating a standard operating practice to ensure consistent and effective implementation of TB interventions.
• Social and behaviour change communication (SBCC): Our SBCC activities focus on strengthening the outcomes of the TB Recovery Plan, which aims to accelerate reduction in TB incidence and TB mortality. The focus is on creating demand for TB testing and treatment services through advocacy, communication and social mobilisation. We are supporting the National Department of Health in designing impactful END TB campaign materials to amplify awareness and engagement nationwide. Additionally, in Sedibeng district, we have initiated a groundbreaking assessment to understand why TB patients are being lost to follow up, and use the findings to improve retention in care. Using the NUDGE framework, we aim to identify behavioural patterns and craft interventions that improve treatment adherence. This approach will be replicated in other provinces across the country.
• Strengthening NTP planning, monitoring and accountability: The TB TSU strengthens communication and coordination between provinces, districts and implementing partners through provincial support visits and provincial programme reviews conducted on a quarterly basis. Through the development of impactful TB dashboards, the TSU has enabled provinces and districts to focus improvement efforts on areas of underperformance. Our work encompasses strategic guidance and technical support to ensure that provinces are equipped to implement and sustain TB policies and guidelines efficiently and effectively. 

By embedding technical experts within the National Department of Health, TSU enhances implementation systems, fosters skills transfer and institutionalises performance review processes. Our approach is rooted in leveraging data to drive accountability, ensuring that TB interventions translate into measurable impacts.