TB/HIV SUPERSION AT CEEGBAH CLINIC

1. GRAND BASSA COUNTY HEALTH TEAM
CEEGBAH CLINIC, DISTRICT#4, GRAND BASSA COUNTY,LIBERIA
SUPERVISION REPORT TB/HIV (PMTCT, HCT)
CONDUCTED BY: JAMES V.T.TUCKOLON
TB/HIV FOCAL PERSON(BACHT)
DATE CONDUCTED: JULY 31, 2017

2. 1.1. Introduction
Ceegbah Clinic is one of District #4's five health facilities. The population of Ceegbah Clinic was
12,803 in 2017. At the clinic, there were eight health care providers (2 professional staffs and 6
other auxiliary staffs).The TB/HIV program is run by the ministry of health with support from
Global Fund.At each county in Liberia,the program is headed by the TB/HIV Focal person with
the responsibility of providing training and supervision in each health facility in the county.
The main purpose of the supervision was to conduct TB/HIV supervision and quarter one and two
data collection .
At 8:00 a.m., the TB/HIV Focal Person came at the clinic and met with eight staff members who
were providing a presentation on the Logistic Management Information System (LMIS).The
dispenser was giving a presentation to the staff about Stock Status Reporting and
Requisition(SSRR) form information. Self-introduction was made, and the purpose of visit at
health facility was done for all. Starting at 8:00 a.m. and finishing at 2:00 p.m.)

3. 1.2.Findings or results on (TB) Quarter 1& 2(January-March& April-June 2017)
 During quarter 1 smear positive TB was reported, whereas quarter 2,2017 two
extra-pulmonary patients were transferred in
 There was a challenge in TB recording and reporting by the care provider, but
mentoring was done how to fill in all of the registers and the treatment cards.
Mentoring was also done on childhood and adolescent TB case detection
 There were limited TB treatment cards and sputum request form at the facility,
but TB/HIV focal promised to provide them on August 1,2017
 TB AFB reagents were available at the time of the supervision
 The OIC was educated to improve TB and HIV collaborative activities
 Anti TB Drugs available most especially adult
1.3.Results/findings HIV (PMTCT/EMTCT) January-June 2017
 In January, there were 46 pregnant women pre test counseled, tested and post test
counseled for HIV from the HCT ledger the same in the HMIS report and 0% positivity
 In February, there were 9 pregnant women pre test counseled, tested and post test
counseled for HIV from the HCT ledger and same in the HMIS report and one 37 years
old positive with HIV type 1&2 in stage 1 started with TDF+3TC+EFV and
CPT February 14,2017(11% positivity of the total tested)
 In March,37 pretest counseled, tested and post tested counseled and one 22years old HIV
positive of type one(started ART and CPT in April at the time in march ART and CPT
were not in the facility(started ART and CPT April 15,2017,the same Option B+ protocol)
 April, there were 16 persons attended ANC all pretest counseled, tested and post test
counseled for HIV with no positive clients. One exposed infant identified, the child of
the 37 years old HIV positive mother(started NVP syrup April 15 and CPT syrup may
23,2017)and another exposed infant identified, the child of 22year old positive
mother(child started NVP syrup July 15,2017 but not yet eligible for CPT syrup)

4.  In May, HIV testing was not fully done due to stock out of test kits in the health facility
and also in the county
1.4.HCT (January-June 2017)
 In January, total male pretest counseled, tested and post test counseled for HIV
was ZERO, Females total were 2 and ages >25 and no positive client reported
 February, total male tested 5(age<15-two,age 15-24-one,age >25 two) and one 18months
old male positive of HIV ,identified during IMNCI care and the child was referred to
LGH, total female -2(age<15-zero,age 15-24-one,>25 one) one 20 years old positive client
reported but refused her status
 March – total male 3 (age<15-one, age 14-24 –zero, age>25-two) and no male client
reported HIV positive, total female 5(age<15-one, age14-24-one, age>25-three) two HIV
positive females identified (1yr 6months and 30yrs old). The child care giver carried the
child to the clinic and she was diagnosed for malnutrition and the care giver was not the
mother of that child. The OIC referred them to LGH, no feedback as to whether the child
is on treatment. The 30yrs old female refused her status and she is in the community
without treatment.
 April total male 1(age<15-zero,age14-24-zero,age >25-one),the one male age 29yrs
was positive and also refused treatment, total female 1(age<15-zero,age14-24-zero,age
>25 one) and she was negative
 May only one female age >25 tested HIV negative
 UP to present no HIV test kits in the county
1.4.1. Action Taken
Action taken towards those who refused treatment, OIC or a screener to find a way to get them
into treatment and consider their counseling skills.
Mentoring was provided on how to talk to someone who is HIV positive about the benefits of
treatment and any associated benefits.

5. 1.5.Anti- TB Drugs or Supplies
 One box of 4FDC and one box of 2FDC
 No TB treatment guideline
1.6.HIV Drug or others Supplies
 TDF+3TC+EFV=2Cans(60tablets)
 NVP Syrups=2bottles
 LPV/r=none
 CPT stock out -3wks
 No HIV test kits-stock out since may 2017
 No new HIV treatment guideline
 No BCC OR IEC Materials
1.7.Other Essential Drugs or Supplies and Other services and Gaps
 No examination gloves since one month
 ORS Stock out -3wks
 Quinine PO stock out -1wk
 Quinine iv stockout-2months
 Erythromycin stockout-2months
 Children PCM stock-out -1wk
 One Functional incinerator, placental pit
 No functional hand pump
 Waste management system in place
 No lightening system, deliveries are done with touch light
 System in place for presentation(health services)as observed during the supervision visit
1.8.Human Resource Issues
 Two vaccinators are not on incentive
 One screener is not incentive
1.8.1.Action taken on the above gaps observed
 To brief CHT on some gaps observed

6.  Vertical programs to support supervision in order to improve TB and HIV services in the
county
 One computer lab top for reporting
THE ABOVE PHOTOS SHOW TB/HIV FOCAL PERSON IN RED JACKET AND THE CLINIC
STAFFS

7. FIRST ANC VISIT WITH PMTCT SERVICE BY Officer In Charge (OIC)
PUBLISHED September 21,2021