1. Washington D.C., USA, 22-27 July 2012www.aids2012.org Engagement of Community Volunteers for Improving Access to TB and HIV prevention, treatment and care services in Ibadan, Nigeria: the PLAN Foundation/TB CARE I Experience Obatunde Oladapo Executive Director: PLAN Health Advocacy and Development Foundation

2. Washington D.C., USA, 22-27 July 2012www.aids2012.org Background The TB/HIV twin epidemics should be addressed jointly at community level. PLAN Foundation engaged community volunteers (CVs) for improving access to TB/HIV prevention, treatment and care services in 5 Local Government Areas (LGAs) of Ibadan, Nigeria.

3. Washington D.C., USA, 22-27 July 2012www.aids2012.org 24 communities were selected from high TB-prone areas, high density areas and hardly-reached communities. A consensus meeting involving various community stakeholders was held during which 50 CVs were selected to facilitate active referral of TB suspects to DOTS centres and linkage with HIV testing services in ART clinics and other healthcare facilities in the areas. methods

4. Washington D.C., USA, 22-27 July 2012www.aids2012.org Community stakeholders include TBLS in the LGAs LACA Managers in the LGAs CSOs working in the LGAs Religious leaders Reps of Private Medical Practitioners TBAs/Voluntary Health Workers Patent Medicine vendors ATM Program Officers in the state

5. Washington D.C., USA, 22-27 July 2012www.aids2012.org consensus meeting in pictures

6. Washington D.C., USA, 22-27 July 2012www.aids2012.org The CVs were trained on the basics of TB, suspects‘ identification, defaulter tracing, adherence support and TB/HIV relationships. They were involved in providing treatment support and follow-up services for smear-positive cases, linkage with HIV testing and treatment for dually-infected persons; and organizing community mobilization.

7. Washington D.C., USA, 22-27 July 2012www.aids2012.org CVs training in pictures

8. Washington D.C., USA, 22-27 July 2012www.aids2012.org community mobilization in pictures

9. Washington D.C., USA, 22-27 July 2012www.aids2012.org Monthly CVs review meetings were held while PLAN Foundation staff provided supportive supervision to the CVs in communities. The monthly CVs review meetings provide opportunity for reviewing the work of the CVs, collating monthly reports of referrals and follow- up done by the CVs and addressing challenges that may be encountered on the field. The supportive supervision helps in sustaining linkages between the TBLS and CVs, ensuring that records of referrals by the CVs are properly kept and addressing issues needing urgent attention.

10. Washington D.C., USA, 22-27 July 2012www.aids2012.org monthly CVs meeting in pictures

11. Washington D.C., USA, 22-27 July 2012www.aids2012.org supportive supervision in pictures

12. Washington D.C., USA, 22-27 July 2012www.aids2012.org sample of flyers produced

13. Washington D.C., USA, 22-27 July 2012www.aids2012.org sample of flyers produced

14. Washington D.C., USA, 22-27 July 2012www.aids2012.org There were steady and significant increases in number of TB suspects referred by CVs between project onset in June 2011 and October 2011. TB clients referred to DOTS centres for screening were: June - 47; July - 56; August - 118; September - 274; October - 238 totaling 733 for the period. Of these, 78 of the suspects were smear positive cases while 25 were dual infected with TB and HIV. Results

15. Washington D.C., USA, 22-27 July 2012www.aids2012.org Monthly total referrals by CVs

16. Washington D.C., USA, 22-27 July 2012www.aids2012.org Total referrals by LGAs

17. Washington D.C., USA, 22-27 July 2012www.aids2012.org Engaging CVs is effective in identifying, referring, supporting and following up TB suspects and persons infected with TB and HIV. CVs live in the community, understand the terrain in which they operate. Engaging them has proven very effective in contact tracing as well as defaulter tracing. Conclusions

18. Washington D.C., USA, 22-27 July 2012www.aids2012.org There is the need for linkage of TB and HIV services as a strategy for detecting HIV infection among people with TB. Community mobilization through CVs helps to increase awareness about TB and HIV in communities. There should be improved support and motivation for CVs as vital linkages to communities TB/HIV interventions.

19. Washington D.C., USA, 22-27 July 2012www.aids2012.org co-authors Amos F. Omoniyi World Health Organization (WHO), TB/HIV Dept, Abuja, Nigeria, Emmy van der Grinten KNCV / TB CARE I, Country Office, Abuja, Nigeria Sunday A. Akinyosoye PLAN Health Advocacy and Development Foundation, Ibadan, Nigeria (PLAN Foundation) Johnson K. Ayoola PLAN Foundation

20. Washington D.C., USA, 22-27 July 2012www.aids2012.org acknowledgement PLAN Foundation is grateful for the funding provided for the project by TB CARE I which is a collaborative funding mechanism by USAID, KNCV and the American Thoracic Society (ATS)

21. Washington D.C., USA, 22-27 July 2012www.aids2012.org Thank you!