- Case management
- Training health workers
In January 2015 KalaCORE together with IMA launched an emergency response for VL in South Sudan. Two mobile teams were formed and have since been conducting health facility visits to prove ad-hoc support to health facilities all over the country. Teams have travelled to inaccessible areas, often completing their journeys on foot.
KalaCORE has been supporting health facilities by procuring drugs and diagnostics, providing basic equipment and light refurbishment, and conducting clinical mentoring visits for health providers. Drugs capable for the treatment of VL patients have also been procured and distributed, with a buffer stock kept for rapid response.
As of October 2018, 46 facilities in VL endemic states have been actively supported by KalaCORE, including facilities re-activated and upgraded. In most facilities at least one person has been trained in the last year, rapid tests and first line drugs have been available with no stock ruptures in last 3 months and VL guidelines, SOP's have been present in treatment wards and laboratories operating at basic GLP standards in place.
- Health education
KalaCORE has worked on improving awareness and treatment seeking in South Sudan through development and updating of appropriate IEC materials in coordination with the Ministry of health, UNICEF and WHO. The IEC materials were officially launched in October 2017. The IEC materials have also been translated into 4 local languages which are spoken in the Kala Azar endemic States. These languages are Arabic, Nuer, Dinka and Toposa, training of health workers and community leaders on the use and dissemination of the IEC materials and the health messages and distribution of the IEC materials to all the endemic States. By February 2019, around 61,235 people have been reached by IEC/BCC activities and a total of 5,972 IEC materials had been distributed.
- Improving surveillance
The deteriorating security context, remoteness of health facilities and difficulties in communication have been major obstacles to timely reporting of VL in South Sudan. Since the start of KalaCORE mobile teams have been providing training, health education and pre-positioning diagnostics and drugs and when needed have also been investigating and responding to reports of suspected VL cases or outbreaks in new sites. suspected cases. From 2016 onwards, KalaCORE’s mobile teams also started collecting retrospective data address VL data gaps.
KalaCORE has been advocating with the Ministry of Health and other stakeholders for strengthened reporting of VL cases An incentive-based scheme that encourages health facilities to regularly submit VL data, was thus developed and by April 2016, MoUs were signed with 6 health facilities and county health departments to begin its implementation. By October 2018, another 10 facilities joined the incentive scheme thus allowing for improvement of reporting.
The South Sudan team has also worked on drug supply-chain strengthening and improving drug surveillance where possible and KalaCORE has also supported the Ministry of Health through the provision of laptop, printer, communication gadgets (e.g. modems) and office furniture to improve on data collection and surveillance.
- Improving surveillance
KalaCORE introduced DAT testing in the National Public Health Laboratory (NPHL) in Juba in 2017 in the attempt to reduce the lead time for sample processing. Staff in the reference laboratory were trained inconducting DAT testing procedure. They were provided with DAT equipment and supplies which include refrigerator, automatic pipettes and microtiter plates. The reference laboratory was also provided with the first batch of reagents. The staff in the health facilities were also trained in collection, storage, preservation and transportation of DAT samples and provided with filter papers.
Tents for admission of patients and basic equipment such as weighing scales, stethoscopes, thermometers etc, have also been distributed to centres in South Sudan and training of performance of RDT Rk39 and the diagnostic algorithm to identify the cases that will require DAT test.
- Training health workers
An estimated total 1,392 health workers have been trained from January 2015 to October 2018 - either on an ad hoc basis by the clinical mentoring teams during visits to remote health centres or at formal, central trainings in Juba. KalaCORE supported IMA emergency health teams conduct training in the health facilities in the remote areas for frontline health workers. Training workshops in Juba have been organised by KalaCORE in collaboration with Ministry of Health, WHO and MSF. Training has also been given to senior health workers as ‘Training of Trainers’. Senior health workers do cascade mentorship of the other staff in their respective health facilities. Training has also been monitored and evaluated. Pre-and post-training tests in Juba have been showing a good improvement in test scores.