Sarah Nyangu Poster 2024

Dr Sarah Nyangu

Zambart, Zambia

“Ubumi Bwandi” (My health, my choice): Integrated wellness screening and prevention in Zambia.

Poster Abstract

Background

In Zambia, the screening services for TB and HIV are integrated the NTLP strategic plan aims to integrate other screening services, especially for non-communicable diseases. The overall aim of the project was to implement integrated service delivery (ISD) to improve the health of the population by identifying individuals with undiagnosed TB, and other chronic conditions, as well as providing health information, multi-disease screening and preventive therapies.

Methodology

The project was implemented at two levels of the health system: primary health facility and community hub (placed away from clinic) for a period of 12 months. Enumeration and door to door sensitization of the entire community was done with provision of Ubumi Bwandi loyalty cards to incentivise uptake of health services. A nested qualitative research focused on: community engagement, acceptability and accessibility; costs (health economics).

Results

A total of 5,947 participants were screened for TB; 5,467 were asymptomatic and 480 were symptomatic. Those who reported TB symptoms, 187 had abnormal chest x-rays out of which 41 were diagnosed with bacteriologically confirmed TB. Among those with no TB symptoms, 146 had abnormal chest x-rays out of which 13 were diagnosed with bacteriologically confirmed TB. The study diagnosed a total of 95 clinically diagnosed individuals. ISD screening: 4,700 hypertension, 1,061 HIV, 3,758 alcohol dependency, 615 for cervical cancer screening and 510 eye screening.

Qualitative research: Community members often prefer medical treatment over wellness and prevention approaches, such as TB and non-communicable disease screening. Community members who are in formal/informal employment are hard to reach with the community hub set-up due to busy work schedules. A total of 12 stakeholders were involved.

Conclusion

Active TB case finding with integrated non-communicable disease screening presents a unique opportunity and can be implemented successfully at a primary health facility. Community engagement and stakeholder buy in for ISD is important for effective project implementation.