Strengthening TB Documentation and Service Delivery in Kebbi State through Mentorship and Supervision: The HSCL ACE 3 Approach
In early 2025, routine monitoring and supportive supervision visits by the HSCL USAID-funded Achieving Control of the HIV Epidemic (ACE3) Project revealed major challenges affecting TB services at General Hospitals Koko and Jega in Kebbi State.
Issues identified included missing HIV status for registered TB clients (ROCs), outdated TB registers, incomplete presumptive TB case records, shortages of HIV testing kits, a non-functional Truenat machine, and long turnaround times for GeneXpert results, all contributing to delays in diagnosis and treatment initiation.
The HSCL ACE3 technical team implemented on-the-spot improvements in data management and documentation, working side-by-side with facility staff to update patient records and correct documentation errors, ensure accurate tracking of presumptive TB cases. The team also traced and updated incomplete retention of care (ROC) information, and provided hands-on mentorship on real-time, accurate record-keeping.
Systemic issues, including equipment repairs, test kit supply chain gaps, and human resource needs were escalated to the State TB Program Manager for action, ensuring stakeholder engagement in finding sustainable solutions.
Impact Achieved
- Improved TB Documentation:Updated, accurate records enhanced reporting on TB/HIV co-infection rates and enabled timely treatment initiation.
- Strengthened TB–ART Collaboration:Improved integration between TB and HIV services created a smoother continuum of care.
- Ownership and Accountability:Health workers demonstrated greater commitment to maintaining high-quality records.
- Streamlined Data Management:Adoption of ad-hoc TB–ART registers at ART clinics improved point-of-care documentation.
This intervention shows how targeted mentorship, coupled with stakeholder engagement, can strengthen health systems. The practical solutions developed, including ad-hoc TB–ART registers can be scaled to other HSCL ACE3-supported facilities across Kebbi State.
By addressing immediate service delivery gaps while advocating for long-term systemic improvements, HSCL ACE3 has set a higher standard for integrated TB/HIV care in Kebbi State, ultimately improving health outcomes for the population.