Center for Health Market Innovations (CHMI)

Programs

Improving TB Treatment in the Prisons

last updated Oct 25, 2011

Overview

Implementing organization: 
APHIA II Eastern
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%

Funding

Primary Source of Funding: 
Donor
Additional Source(s) of Funding: 
Government
Funders: 
Government of Kenya, USAID

Scale

Personnel Employed: 
10-49
Summary: 

This project has introduced TB screening in the prisons instead of them going to the district hospital.

Program goals/rationale: 

With only one bus available as the means of transport for the whole institution, transporting prisoners to the hospital for medication was almost impossible. This was a particular issue with regards to TB patients who need daily medication, which lead to a high default rate and sometimes, death. It is alleged that the wardens, due to ignorance, often order the prisoners to consume their entire weekly dose in one day to avoid the inconvenience of visiting the health facility on a daily basis. Through the joint efforts of APHIA II Eastern and the Ministry of Health working in collaboration with the management of the Embu Prison, this gap has been quickly identified and measured to solve the problem.

The facility is currently diagnosing 40 TB cases monthly up from the previous 5. All the TB patients are offered HIV testing, which has resulted in a 100% uptake.

Key program components: 

A microscope has been procured for the facility and the Ministry has stationed a laboratory technician on a full time basis in the Prison clinic. Similarly, the Ministry of Health is supporting a clinician to be available every Thursday which lessens the burden of transporting prisoners to the Provincial General Hospital which is also a security risk. Through these interventions, all the TB treatment is now available at the Prison clinic. Additionally, they have procured an ambulance to transfer only emergency cases to the district hospital.

Efforts are being made to make Embu Prison a model site with complementary interventions premised on the continuum of care model. As a result, Community Sensitization Programs have already commenced reaching out to the wardens and prisoners to address the information/knowledge gap. Negotiations with the Ministry of Health are in top gear to make Embu Prison clinic a satellite ART facility, and introducing PLWHA support services among other interventions. The underlying mission is to provide a package of all the interventions supported by APHIA II Eastern to this one facility which can also be used as a case study to show case the positive impact of an integrated approach to service delivery. Measures have already been put in place to replicate the same to Meru Prison.

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