Nigeria

Nigeria is a federation of 36 states with 774 administrative units referred to as Local Government Areas. The country has an estimated population of 126 million. The autonomous status of states tends to constrain the control that the Federal Government can exercise over states and local governments in terms of resource allocation for various sectors, including health and education. Nigeria established its National TB and Leprosy Control Program (NTBLCP) in 1989. The NTBLCP operates along the three levels of government, National, State and Local Government Areas, with coordinating offices at each level. Health facilities at the peripheral level are the operational units of DOTS services. There are currently 2,015 health facilities providing free TB and DOTS services in Nigeria.

Nigeria adopted the DOTS strategy in 1994. At the beginning of 2002, only 21 of the 36 states were implementing DOTS, but with assistance from partners such as TBCTA and others, the country successfully extended DOTS services to all 36 states by the end of 2004. Nigeria ranks fourth among the 22 high-burden countries for TB in the world. WHO estimates that 374,000 new cases of all forms of TB occurred in Nigeria in 2004 and that incidence is increasing. Based on these estimates, the case detection rate is still low, as at the end of 2005 only 26 percent of estimated smear-positive cases were actually notified under the DOTS program in the country.

HIV/AIDS is also a serious concern in Nigeria. The rate of HIV incidence is about 5.8 percent in the general adult population, which represents about 3.47 million people living with HIV/AIDS. Some one million adults have both HIV and TB infection, comprising 50,000 TB cases every year dually infected with HIV and needing both anti-TB and antiretroviral treatment.

TB CAP Highlights Nigeria

TB CAP Highlights Nigeria
The National TB and Leprosy Training Centre in Nigeria is situated in a small village near Zaria Town in the Northern part of the country. The surrounding area is very dry and consists mainly of farmland. There are scattered villages around the center where leprosy patients and their families are living.

Since 1990 the center serves as a National Training Centre for all cadres of staff: general health workers, nurses, lab technicians and doctors. Different courses are organized on Clinical TB and Leprosy, Laboratory and all other aspects of Program Management.

During the past years the center has developed from a national training institute to an international training institute. With Government support around fifteen buildings have been added to the institute amongst which a new auditorium, student guesthouse, wards, OPDs, laboratory, radiology unit, operating theatre and administrative buildings. They now call it a small university.

The center has built a very experienced team of internal and external facilitators. The hospital has a capacity of 140 beds and provides patient care for TB, HIV and leprosy. The hospital serves as a practical site for the students of the training centre.

The institute receives support from the Nigerian Government and partners (Netherlands Leprosy Relief, Institute of Human Virology and TB CAP).

Due to the great improvements the NTBLTC was selected to become an International Training Center for Anglophone Africa under the Institutional Capacity Building Project of TB CAP/USAID.

A team visited Zaria for the first time in November 2007 for initial assessment. After the visit a training needs assessment was done, the course was designed by the Zaria Team and logistics preparations were made. After all these years of hard work on October 27th 2008 the opening ceremony of the first International Training Course was held.

21 Participants (5 women and 16 men) from 7 countries came all the way to the little town in the North of Nigeria. They came from far away: from Tanzania, Ghana, Gambia, Kenya, DRC, Zambia and Nigeria. For 2 weeks they concentrated on “Data Management and Supervision”. They did a gap analysis and prepared an action plan for their respective countries.

During the closing ceremony the Principal of the Training Center recalled that ten years ago he had a dream: Zaria should become an International Training Centre. He narrated that while he was guiding the participants for a tour around the premises on the first day he realized that his dream came true. TB CAP was there and helped to make the dream happen.