USAID’s Local Service Delivery project saves lives of TB clients through timely community interventions


“I agreed to start TB treatment and now in my fifth month, no longer have cough, have gained weight and resumed my work as a builder”.  Mulelo Noah



April 2022- As COVID 19 affected the world economies and health systems in 2021, Tuberculosis (TB)/HIV care in Uganda was significantly affected by the national lock down directives and stigma against clients reporting at health facilities with cough. The restriction on movement and gatherings in public places negatively impacted on tuberculosis (TB) treatment.  Diagnosis of TB among clients visiting health facilities and in the communities was at its lowest.

Mulelo Noah, 40, a resident of Wanyange Hill village, Mafubira Division, Jinja City had a cough and chest pain for one year that did not respond to the cough medication he was using. His fear of an HIV diagnosis owing to the significant weight loss prevented him from visiting the hospital.

“I had cough that had lasted over one year with chest pain and had lost a lot of weight. I thought I had HIV. That is one reason why I feared to go to the hospital thinking they will tell me that I had HIV. I could not sleep, so I resorted to taking locally brewed alcohol (waragi) to sooth my throat and also help me get sleep”, says Noah.

The USAID funded Local Services Delivery Activity (LSDA) implemented by Uganda Protestant Medical Bureau (UPMB) supported health facilities to implement community TB identification as a pilot intervention while observing COVID-19 Standard Operating Procedures within Busoga sub region. The supported PNFP health facilities in Busoga sub region had only identified 42.5% (287) of the expected 676 TB clients in six months. This meant that approximately 389 (57.5%) of all the potential TB patients were in the community undiagnosed, possibly transmitting TB and at risk of dying. To close this gap, Facility and community teams were trained to identify, refer and manage TB clients. Community health workers were engaged to support facility health workers to conduct TB hotspot mapping, community sensitization, TB outreaches for case identification and linkage to health facilities for care. Clients were educated on the dangers and effects of TB and importance of seeking treatment early.  Through these interventions, 774 (114.5%) TB clients were identified in the next semi-annual period (surpassing the target 676 TB clients). All the 774 TB clients were started on treatment. Lives of unknowing TB infected persons were saved through this initiative.

In November 2021, St. Benedict Health Centre III, supported by LSDA conducted a TB hotspot mapping exercise with community linkage facilitators and village health teams in Wanyange Parish.  “The ‘Basawo’ (medical team in local language) came to the place where we were taking ‘waragi’ and requested to test us for TB and HIV. I was afraid to be tested but with counselling from the health workers, I agreed to be tested. They took off a sample of sputum and blood from me. They told me I was HIV free but should come back the following day to receive my results for TB,” recalls Noah.  “The following day, I was told I had TB. The nurse counselled and advised me to start treatment. I could not believe I would be okay because I had taken several treatments for cough but all would not help me”.

Noah was started on anti TB medication at St. Benedict and is being monitored by the medical team. “I agreed to start TB treatment and now in my fifth month, no longer have cough, have gained weight and resumed my work as a builder” says Noah.

Local Service Delivery for HIV/AIDS Activity (LSDA)

Plot 728, Namirembe, UPMB Close (off Balintuma Road), Mengo, Kampala, Uganda

For more information, contact the Chief of Party, Johnson Masiko on


April 2022                                                                       

This success story is made possible by the generous support of the American People through the United States Agency for International Development (USAID). The contents of the story are the responsibility of UPMB and do not necessarily reflect the views of USAID or the United States Government.