Health Committee project (2024-2025)

This initiative placed community leadership at the centre of TB accountability in Khayelitsha. Through mentorship, community-led monitoring, outreach events and media advocacy, champions helped identify service gaps and promote practical solutions to improve TB testing and prevention.

Project description

We will develop TB policy briefs to guide TB champion workshops for 18 representatives as part of a mentorship programme.

TB Proof will facilitate workshops with community representatives to identify barriers to TB testing that can be strengthened through accountability and demand generation activities.

We will mentor them as TB champions to present recommendations to the district-level Department of Health, collaborate with civil society organisations (CSOs) to advocate for district-level priorities and leverage existing advocacy platforms to maximize effectiveness and sustainability. We will implement a TB awareness campaign on TB policies to increase TB testing and support TB champions in CLM activities to increase accountability for quality of service delivery.

Aims

The project aimed to strengthen accountability for TB policies through supporting district health councils, clinic committees, and hospital boards in Khayelitsha in the Western Cape.

Achievements

Strengthening Accountability at the Community Level

Through the TB Champions Mentorship Programme, 18 Khayelitsha Health Forum (KHF) members completed five workshops on the National Strategic Plan for HIV, TB & STIs (NSP) 2023-2028, TB Recovery Plan, updated Targeted Universal TB Testing (TUTT), TB Preventive Therapy (TPT) policies, and advocacy skills.

KHF members conducted Community-Led Monitoring (CLM) at eight local health facilities. Recommendations based on CLM findings included refresher training for health workers, community awareness campaigns, and off-site TB testing to reach populations not accessing clinics.

Increasing Political Commitment for TB Policy Implementation

TB Proof supported KHF members to attend weekly facility-level meetings and share facility-specific CLM reports with District TB Coordinators and facility managers, highlighting practical recommendations to strengthen TB services.

KHF also contributed to provincial TB advocacy efforts, informing the Western Cape TB Task Team’s plans and community priorities that will be presented at high-level government coordination meetings.

Raising Public Awareness of TB Policies

TB Proof co-hosted five community TB awareness and offsite testing events, reaching 184 people. Champions also delivered weekly TB talks at clinics, participated in youth and Women’s Day activities, and supported “Close the Gap” outreach sessions.

To expand reach, champions and TB Proof featured in four isiXhosa radio interviews and radio advertisements on Radio Zibonele, reaching an estimated 180,000 listeners. They also co-authored an op-ed in E-Health highlighting the role of local leaders in TB awareness.

Community-led initiatives were featured in The Star on World TB Day, while Busisiwe Beko spoke on SABC and Goodman Makanda on Expresso TV, emphasising gaps identified through CLM, the role of clinic and health committees, and the importance of TB testing and TPT access.

Thapelo Aphiri, a television star and the drama director in Hammanskraal, that helped to develop theatre plays to address barriers in the TB care cascade.

Project Achievements

We developed TB and advocacy skills workshops aimed at CHWs and their outreach team leaders. Using principles of human-centred design, CHWs used a card deck to identify local gaps in the TB care cascade.

CHW designed an intervention to address stigma as a barrier to accessing care. They used theatre to engage the community in conversations about TB and stigma. CHW TB champions presented on radio interviews and contributed to online articles.

They co-developed and presented an advocacy letter in-person to the Minister of Health in 2019 for World TB day. Partnerships with health workers at clinic level augmented CHW engagement with care and enhanced collaboration through setting up TB war rooms (multi-sectoral meetings with the Departments of Health, Social Development, Education, Agriculture) designed to improve TB care delivery and close gaps in the cascade of care.

CHWs presented their key needs to the National Department of Health to advocate for standardised high quality training and adequate infection prevention equipment alongside leading advocacy organisations in 2020. Report available here.

Our advocacy projects

TB Preventive Therapy

Some people may have latent TB – where some is infected by the TB bacteria but they do not show TB symptoms and cannot infect others.

TB Stigma Project

Stigma is a term describing the feeling of being ashamed, or experiencing societal disapproval in the way that other people treat you.

All oral drug-resistant TB Treatment

For many years patients were given a difficult choice: die because of drug resistant TB or become deaf as a results of the treatment.

TB IPC Training

Healthcare workers (HCWs) are three times more likely to be infected by TB than the general public and six times more likely to be hospitalized with drug-resistant TB.