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Hope for Future Generations as part of its 20th Anniversary has launched a menstrual hygiene initiative aimed at supporting 500,000 girls with 3 million sanitary pads.

Dubbed Pads for Girls Everywhere, the initiative was officially launched on Tuesday 28th July, 2020 with a donation of 1,000 sanitary pads to about 220 girls from Kadjanya and Pediatorkope, two communities in the Ada East District of the Greater Accra Region of Ghana.

Speaking at the launch of the year-long intervention at Kadjanya, the Executive Director of HFFG, Cecilia Senoo explained that the project seeks to promote good menstrual hygiene management for girls (both in school and out of school) including those living with disabilities.

Young girls receive sanitary pads from HFFG

She indicated that HFFG by this project wants to break the negative social norms around menstruation and engage decision-makers, traditional leaders and opinion leaders to increase the political priority for Menstrual Hygiene at all levels.

“Menstruation should not be a barrier to prevent any girl from achieving her dreams. No girl should miss classes due to lack of sanitary pads. No girl should have health problems with her sexual and reproductive organ because of the use of unhygienic materials,” Mrs Senoo stated.

She called on the Government of Ghana to reduce or remove taxes on sanitary pads to make them more accessible to girls everywhere.

At Pediatorkope D/A Basic School located on an Island Community, 500 hundred sanitary pads were distributed to final year students preparing for their Basic Education Certificate Examination (BECE), as well as those out of school.

Headmaster of the Pediatorkope D/A Basic School, Mr David Numo expressed gratitude for the donation, noting that it will go a long way to boost the confidence of girls in the school, especially as they prepare for their exams.

Queen Mother of the Adibiawe clan in the Ada traditional area, Naana Adiki Manyeyo Adi at a community durbar thanked HFFG for choosing Ada as one of the beneficiaries of the intervention. She encouraged parents to be committed to the provision of the basic needs of their daughters to ensure that they harness their full potentials.

“I thank Hope for Future Generations for donating the pads to us. I thank them for also educating our parents to ensure we have sanitary pads. This will keep us healthy,” Gifty, a final-year pupil of the Pediatorkope D/A Basic School stated.

The Community Systems Strengthening initiative is an approach that promotes the development of informed, capable and coordinated communities, and community-based organizations, groups and structures. Under the initiative HFFG has established strong working partnerships with the Ghana Health Service structure at all levels- structures. Due to this, institutions like the National Tuberculosis Control Program (NTP), National Malaria Control Program (NMCP) and the National AIDS Control Program have provided technical support to the intervention which has reinitiated 19,656 HIV defaulters back on treatment and also helped identified 712 positive TB cases and still counting.

Under the Community Systems intervention of the WAPCAS/Global Fund NFM II intervention, 88 TB champions from 33 districts in 9 regions of Ghana were identified and empowered to undertake contact tracing, intensified case finding, DOT adherence counselling, follow-up on lost cases, drug monitoring at facilities, effective documentation and reporting. TB Champions from January 2019 to July 2020, were able to screen over 17,971 clients out of which 523 people from 6991 presume TB cases tested positive after going through TB testing at the various health facilities. Persons who tested positive were put on treatment.

TB Champions are persons who have been cured of TB and have dedicated their time and resources to serve as advocates in their communities to spread information on TB in order to get persons who might exhibit signs and symptoms of TB to get tested and if positive be enrolled on TB treatment.

Tuberculosis (TB) was declared a global emergency in 1993 by the World Health Organization (WHO). Despite available interventions initiated by the WHO and some countries, the disease remains a key public health concern. The rates of TB infection and its associated burden is unevenly distributed across the globe with greater severity in lower and middle income countries including Ghana.

Tuberculosis (TB) still constitutes a serious public health problem in Ghana. This is irrespective of the implementation of the Directly Observed Treatment short course (DOTS) strategy since 1994; adoption of the World Health Organization (WHO) Stop TB strategy in 2006; and availability of DOTS facilities in most districts in the Ghana.  Accessibility of DOTS services is still not sufficient as majority of the population live at considerable distance from the DOTS centers and most TB diagnostic and treatment centers are located in urban areas. Stigma and discrimination, poor knowledge about TB transmission and cultural beliefs that TB is a spiritual disease, are factors that contribute to poor health seeking behavior and delay or failure to access early health care services.

According to the Country Coordinating Mechanism of the Global Fund, Ghana, the TB burden in Ghana as at 2013 was 290/100,000 – four times higher than the world average of 71/100,000 for that same year. Innovative interventions to increase case detection were therefore urgently needed to ensure a surge in TB case detection.

The Global Fund NFM II, under WAPCAS’ Community Systems Strengthening (CSS) intervention, have trained a total of 88 TB champions from 33 districts in 9 regions of Ghana: Greater Accra, Western Region, Western North, Central, Northern, Eastern, Bono, Bono East and Ashanti. TB Champions are persons who have been cured of TB and have dedicated their time and resources to serve as advocates in their communities to spread information on TB in order to get persons who might exhibit signs and symptoms of TB to get tested and if positive be enrolled on TB treatment. The training was conducted by the National TB Control programme, West African Programme to Combat AIDS and STI’s (WAPCAS), Hope for Future Generations (HFFG) and the Ghana National TB Voice Network. TB Champions serve as treatment supporters. They screen and transport sputum to the health facilities for testing. They also refer presumed TB clients to the facility for testing, follow up on defaulting clients in their communities and lead them back to care. They conduct community sensitization and education on TB, carry out drug pick-up exercises, and undertake peer led referrals for TB clients to the facility for treatment and index testing. Many of them are treatment supporters for the newly diagnosed cases. The aim of these activities is to reach out to the hidden TB clients in the communities and ensure that they are provided with the needed care and services.

“TB Champions are a major stakeholder in the fight against Ending TB in Ghana. This is to say they play a critical role in Ending TB in Ghana through active TB case finding at the community level,” says Mr Jerry Amoah Larbi, National Secretary of the Ghana National TB Voice Network.

TB Champions from January 2019 to July, 2020, have been able to screen over 17,971 clients out of which 523 people from 6991 presume TB cases tested positive after going through TB testing at the various health facilities. Clients who tested positive were put on treatment.

This feat was achieved by the TB Champions through varied strategies which include but not limited to: planning with district and facility TB focal persons, Coordinators and Project Officers to map out high burden communities for intensive contact tracing exercises, visiting very hard to reach communities such as illegal mining areas popularly known as ‘Galamsey sites, ghettos noted for drugs users, sand winning and quarry sites, hamlets and shanty settlements.

From Right to Left: A TB Champion sensitizing a client on TB before screening.

The most significant of these strategies is the transportation of sputum from presumed TB clients to the facility for testing. This has proven to be a very significant addition to the TB case detection process as it has reduced the excuses given for not going for the TB test even when people exhibit symptoms of TB. After testing, TB Champions are provided with feedback on the samples they supply to the health facilities for testing. If positive, TB Champions follow up to clients’ houses to inform them about the results of the test, mostly in the company of the Coordinators or TB focal persons. The TB Champions at this point counsel the clients and agrees on dates to accompany positive clients to the health facility to begin treatment. The Champions at the DOTS centers serve as the treatment supporters for newly diagnosed positive TB clients, meaning they are responsible for ensuring that clients adhere to medication given them until they recover.

Ebenezer Odoom, from the Weija-Gbawe Municipality  in the Greater Accra Region is a beneficiary of the work of TB Champions. He was first diagnosed of TB at the Weija-Gbawe Municipal Hospital in Accra after a short illness. Ebenezer was enrolled on treatment immediately. However, four months into his treatment, he was no longer responding to treatment. After a second examination, it was detected that he was suffering from a type of TB known as the Multidrug-resistant TB (MDR).  The MDR is a type of TB caused by bacteria that are resistant to some of the first-line TB drugs. To cure an MDR TB, he was administered a daily injection in addition to his medication for nine months.

“This was a difficult time in my life. I defaulted the TB treatment but a TB Champion traced me to my house. He kept encouraging me to enroll on the second line TB treatment. The TB Champion told me his story about how he was once in my situation. I agreed to be enrolled on treatment again. I was finally declared free from TB,” says Ebenezer, who has since his recovery volunteered as a TB Champion under the CSS project to identify positive TB cases and to provide treatment support to TB clients in his community.

“The work of TB Champions has been beneficial to the  Komenda Edina Eguafo Abirem (KEEA) Municipality,” explains Jonathan Kissi, a TB Coordinator.

“The benefits include the increase in awareness on TB, increase in the number of samples sent to the lab for further investigation, and the increase in number of TB cases identified.  Through their work they have prevented the emergence of defaulters and prevented the spread of TB through contact tracing and screening,” Mr Kissi adds.