WHO WE ARE
History of TB and Leprosy Control In Kenya
The History of TB and Leprosy control in Kenya stretches back to before the Second World War when leprosy patients were maintained in small “leper settlements” in Kakamega, Lamu, Malindi and Tumbe (2). In 1948, the ﬁrst attempts were made to treat leprosy systematically. Between 1951 and 1957, the Alupe Leprosarium was built in Busia District in Western Province. In 1956, the NTP was created, providing TB control activities that included diagnosis, treatment and occasional mass campaigns using miniature chest X-rays. In the early 1970s, the Government of Kenya with the assistance of the Netherlands Leprosy Relief Association (NLRA) initiated a number of leprosy control projects: the West Kenya and Coast Leprosy Control Scheme and the Meru and Kitui Leprosy Projects. In 1976, these projects were brought together in the national leprosy control programme (NLP). The control of TB was carried out by the NLP until 1980 when the National Leprosy and Tuberculosis Control Program (NLTP) was established, with specialized staff at national, provincial and district level. The role of these staff was to provide technical guidance and supervision of TB and leprosy control activities. Then as now, TB diagnostic and treatment services were delivered within the primary health-care system, at hospital, health centre and dispensary level.
The development of the Kenya health system in relation to TB control can be divided into four phases: 1980–1998; 1999–2004; 2005–2012 and 2013 to date.
TB diagnostic and treatment services were delivered within the primary health-care system
Diagnostic tests and treatment were available free-of-charge in all government facilities
Health sector reforms led to decentralization of responsibility for providing health services to the district level in 1983 through the ‘District Focus for Rural Development (DFRD)’ strategy.
The NLTP was actively involved in health sector reforms leading to the first NHSP focusing on decentralization and an essential health package.
The NLTP strategic plan 2006–2010 was developed and was in line with the second NHSP stressing on the need to strengthen the infrastructure and human resources for health.
TB/HIV collaborative activities were rolled out throughout the country
In 2007 the Ministry of Health raised the status of the NLTP in the ministerial structure from programme to divisional level by creating the Division of Leprosy, TB and Lung Disease
2013 to date.
The Division saw a name change to the National Leprosy, Tuberculosis and Lung Disease Program (NTLD-P)
The NTLD-P conformed to the new constitution which led to devolution of Health services resulting in delivery of TB control activities in the 47 Counties.
The NTLD-P receives funding from the Government of Kenya and Donors/Partners including: GF, USAID, CDC and JICA.
Health Service Delivery
The NTLD-P implements activities in the 47 Counties through CTLCs, SCTLCs, Health facility staff and Community Health Volunteers. This is done in 3320 treatment facilities, 1920 diagnostic and 295 TB control Zones.
The NTLD-P works together with NASCOP to implement TB/HIV collaborative activities: HIV testing,CPT, ART, ICF and IPT.
The NTLD-P engages the Private sector in provision of services with approximately 20% of TB patients being managed in the private sector.
The Community is not left out in TB service delivery as the NTLD-P works with CSOs and CHVs to do defaulter and contact tracing.
The NTLD-P has 45 staff at the National level and is supported by 47 CTLCs and 295 SCTLCs at County and Sub County levels.