Strengthening Local Capacity to Deliver Sustainable Quality-Assured Universal Coverage of Clinical HIV/TB Services in Lubombo Region,

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Swaziland is among the countries with the most severe HIV and TB dual epidemic in the general population. The current annual adult HIV incidence is estimated as high as 2.4%. HIV prevalence among adults aged 18-49 years is 31% and TB incidence rate is 1380/100,000 persons. About 6,000 TB cases are expected to be diagnosed by 2015. Approximately 75-80% of TB cases are co-infected with HIV. HIV prevalence among pregnant women in Swaziland is among the highest globally at 41%. While Swaziland has made significant strides in addressing the HIV and TB dual epidemic, more effort is needed to reach universal coverage at new WHO 2013 recommended guidelines; improve delivery of quality clinical services across the entire continuum of HIV testing, care, treatment and retention such that it is seamless, comprehensive, and integrated within existing structures; and increase capacity for sustainable MOH stewardship at the national, regional, and facility level. Although Swaziland has made great progress in scaling up HIV and TB clinical services, including TB/HIV collaborative activities (Intensified TB case finding (ICF), Isoniazid Preventive Therapy (IPT) and TB Infection Prevention and Control (IPC)), critical gaps and missed opportunities exist in reaching children, adolescents, and key populations (KP) with HIV services, reaching pregnant women and TB clients with ART, efficient utilization of limited resources, and strengthening structures for long term sustainability of quality-assured programs.

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