The SPARK-TB (Slum Partnerships to Actively Respond to Tuberculosis in Kampala) project implemented in Uganda through the support of the Stop TB Partnership initiative TB REACH, provides a valuable and innovative model for diagnosing and treating TB that takes into account the social and economic factors that promote its spread in low-income, urban areas.

People living in Kampala’s slums frequent small independent clinics – sometimes located in a shanty or even a shipping crate. Through an intensive capacity-building effort, SPARK-TB worked with providers in such clinics in Kampala and surrounding districts to provide quality TB diagnostic and care services and to link them to Uganda’s national TB programme.

Through the project, private for-profit clinics in the slums were brought into the SPARK-TB partnership and branded with a bright yellow logo that indicated TB testing was offered on site. The Union worked closely with the staff of these clinics, training the health workers and laboratory personnel, providing support supervision and quality-assured anti-TB medications, disseminating national TB guidelines and providing tools for recording and reporting data. The capacity of the clinics’ laboratories was further strengthened by enrolling them in the national External Quality Assurance scheme to improve the accuracy of their diagnoses.

In order to increase demand for the services offered by the private clinics, SPARK-TB organised health camps that provided a platform not only to sensitise the community but also to offer free TB screening and diagnosis, free HIV testing services and referrals to care and treatment at the clinics.

When SPARK-TB got off the ground, only six of the clinics serving this mostly poor population offered TB services. Within two years, more than 70 private clinics in Kampala were providing quality TB diagnosis and care, and some 1,700 TB patients were diagnosed and started on treatment. All of these patients received regular home visits from community health workers, who monitored adherence to treatment, provided additional health education and addressed patients’ questions.

One of the most important features of the project was that all of the people administering it were hired from the local community, both through paid and volunteer positions. These community health workers had previously been supporting other health interventions, such as immunisation campaigns, but before SPARK-TB started they weren’t equipped to help their communities fight TB. Through this community systems strengthening effort, the project built capacity that has outlasted the project itself.

The programme was successful enough that with additional support from TB REACH, it was expanded to 12 other major urban areas in Uganda, and was incorporated into the national strategy.


2014 final report on phase one (Kampala) (PDF 1.3 MB) 

Photo: Will Boase/The Union