Voluntary Medical TB Testing (VMTBT) Can Make People Connect to What Can End TB By 2030 in Greater Masaka Region-An Interview with Sebbula Francis By Tom Muyunga-Mukasa
Voluntary Medical TB Testing (VMTBT) Can Make People Connect to What Can End TB By 2030 in Greater Masaka Region-And Interview with Sebbula Francis By Tom Muyunga-Mukasa
Interviewer:
I
am so happy to have met with you. I hope you can spare time so that we talk
strategy about the end to TB, HIV, and Malaria by 2030. Where in the Greater Masaka do you come from?
Sebbula
Francis:
I
come from Kabonera which is now part of the Kimaanya-Kabonera Division of
Masaka City. I am the recently outgoing Kabonera LC (III) Chairperson, I
served for one term from 2016-2021. But I have been doing community service since early 2000.
Interviewer:
This
is quite recent and thank you for serving the community. I am sure this did not
just happen but there must be a history of the desire to serve people. Serving
in the Government whether at Central, Regional or Local has its nuances. Tell
me a little about your nuanced leadership experience.
Sebbula
Francis:
Interesting.
Indeed, there are nuanced experiences for instance one hears a different kind
of English and each sentence has a policy, planning or programming effect. One
must be ready to grasp this language as fast as possible. For instance, a day
at the headquarters cannot end without one hearing such terms thrown around
like school facilitation grants, administration, finance,
statutory bodies, production and marketing, health, education, roads and engineering,
water, natural resources, community-based services, planning, internal audit, locally raised revenues,
discretionary government transfers, conditional government transfers, other government transfers, local development
grant, donor funding, and local development grant. Then come the acronyms. I recall
many such as PAF, SFG, PHC, LG, and the like. Most interesting is the energy,
motivation, and confidence that many people bring with them in the service
community. I cherish those memories and I am so grateful for the time I served
at that level of Government.
Interviewer:
I
am so happy you shared all this with us. What are those acronyms in full?
Sebbula
Francis:
PAF
in full is Poverty Action Fund; SFG in full is School Facilitation Grant; PHC,
LG, and the like.
Interviewer:
Are
these just Political words to be employed in Political Speak? How are these
linked to the good health and wellness of a person in say, Kabonera where you
were a leader?
Sebbula
Francis:
That
is an interesting question, thank you for asking. LG means Local Government.
PHC is Primary Health Care. The Poverty Action Fund (PAF) is a 1997 Government
Policy that together with the School Facilities Grant (SFG) assists the neediest
communities to complete unfinished classrooms or acquire new ones to ensure
that Uganda meets the 1:55 classroom ratio. This meant that there would be
structures, furniture, Latrines, and opportunities to involve or work with
communities and Central Government directly serving through actions including
supervisory roles. So, for a person in Kabonera the schools exist at walkable
distances. This means that both girls and boys access education in their
own familiar communities. It means parents are not burdened by transport fees
or can use the equivalent of food crops to pay for school fees. It also means
school retention for both girls and boys translating into critical education
qualifications that leverage opportunities for employment or further education.
It is my hope that more schools will be provided in my home area.
Interviewer:
I
was intrigued when you mentioned PHC and I am glad there is a deliberate policy
strategy to locate PHC in local governments nearer to grassroots-based
communities. How do you define PHC?
Sebbula
Francis:
Primary health care includes such systems and structures
that support a person's health needs including enforcement, health promotion, disease
prevention, treatment, rehabilitation, and palliative care. It means that
health care is delivered in a way that is centered on people's needs and
respects their preferences. This empowers communities to participate in
demand for quality health services and demand them as a health-seeking
practice.
Interviewer:
Together,
you and I, let us help our readers connect one health, global and public health
to lived experiences and contexts such as engaging in practices to end TB, HIV, and Malaria by 2030.
Sebbula
Francis:
My
experience is that we shall have to use a multi-sectoral approach if we are to
end TB, HIV, and Malaria by 2023. Our performance
must be evidence-based, people-centered, and contextual-driven. For instance, the
climate-change issues we are experiencing mean that we need to engage in
climate-smart activities such as re-forestation; soil regeneration; and
diversifying food production. Such indicators as the number of health seekers
who are reporting at the health facilities should be compounded with efforts
such as garbage removal in our cities, municipalities, or town councils. We must
reason and act around the fact that the non-removal of garbage, letting bushes
grow nearer to the homes, and weather changes are also supporting the
proliferation of mosquitoes. This means more mosquito bites and therefore more
people suffering from malaria. One disease can become a problem for the
immunity of persons and this in turn allows opportunistic infections to affect
this person. Communities must be empowered to take up community-level roles and
engage in them to contribute to the promotion of optimal primary health care
outcomes. When communities are involved, they connect with what matters and it
will mean we have more people involved in efforts to end TB, Malaria, and HIV by
2030.
Interviewer:
You
pointed out many strategies but as we wind down I am interested in the
relationship between TB, HIV, and Malaria. Malaria
is a global problem with about 250 million cases reported, 94% of which are in
Africa. According to the Ministry of Health, Uganda has about 150,000 cases of
malaria every week. Malaria incidence was 320 cases for every 1,000 people
according to the 2022 survey. Uganda is ranked third following the DRC and
Nigeria. Malaria affects the way people fare with HIV and TB. How
you can be part of those mobilising communities to be linked, retained in care, and become involved in health promoters and eradicators of TB popularising Voluntary Medical TB Testing (VMTBT)?
Sebbula
Francis:
Preventing
diseases, prolonging life, and promoting health is easier when people make it a
practice and culture. In the case of TB Prevention and Eradication, there are
some important principles to have in mind: the communities must be organised in
such a way as to foster finding those eligible for tests to address under-diagnosis, link those with TB-positive diagnosis to care to address inadequate TB
treatment and establish a Voluntary Medical TB Testing and Therapy (VMTBTAT)
mechanism to address uneven TB testing, prevention, care, and eradication. We
have a chance to create a virtuous cycle of ambition, demand, resources, and
performance that can bring us closer to ending TB. This has attendant
benefits in that it will contribute to closing
research gaps; advancing novel treatment strategies and simpler, more accurate
diagnostic tests; and seeking to expedite policy translation to ensure
innovations reach communities that will benefit from them. This has
bio-medical-social-economic returns and a reversal of inequalities and
inequities. People living with HIV will be provided TB Preventive care and this
will reduce and address vulnerability to TB disease. People will be taught
about the seven symptoms (cough,
fever, night sweats, weight loss, anorexia, headache and chills) and where to
report for care.
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