URC-SWAZILAND MONTHLY NEWSLETTERNeeraj KaK , URC Senior Vice Presi-dent PST and Ms. Alisha Arthur Smith , Deputy Director of PST. Our colleagues provided technical support for on-going

Improving systems to empower communities

The month of May brought special events which are worth noting, especially because they in-

volved tracking the progress of most projects by both the USAID ASSIST and CDC Lab projects

and motivating the staff. The two key events were the URC Swaziland Update meeting on the

21st of May and the Internal Auditing of laboratories in the country. The URC-Swaziland, Country

Director, Dr Samson Haumba had the following to share about the months activities:

FOREWORD BY THE COUNTRY DIRECTOR

“The updates by the staff on the pro-

gress of each project were quite in-

formative allowing us to see gaps that

we need to fill. Our new slogan

‘Applying Ourselves’ has allowed us to

become a cutting

edge team when

looking at the work

we do. We are indeed

doing great work, but

we can still do more.

In the month of June

we will be expecting

new additions to the

staff. Hopefully these

new additions will

ease the pressure of our

work, smoothening and

improving work effectiveness and

efficiency.

It was also such a privileged to be vis-

ited by our colleagues from HQ, Dr.

Neeraj KaK , URC Senior Vice Presi-

dent PST and Ms. Alisha Arthur

Smith , Deputy Director of PST. Our

colleagues provided technical support for

on-going activities, especially M-Health,

listened to our success stories and challeng-

es in the field, which motivated staff. We

appreciate the visit to our office which is a

symbol of commit-

ment and dedication

of URC towards im-

proving the health

systems in Swaziland.

In the subsequent

month CDC-URC lab

project will support

the Swaziland Health

Laboratory Services

(SHLS) to conduct

laboratory audits by African

Society Laboratory Medi-

cine (ASLM). This activity will require the

CDC-URC lab project to tireless work to

prepare the selected labs for accreditation. I

would like to thank the staff for the work

that has already gone in preparation, I am

opportunistic that the supported laborato-

ries will attain some stars.”

URC-SWAZILAND MONTHLY NEWSLETTER

May 2014 Issue

10 June 2014 Volume 1, Issue 5

Inside this issue:

Headquarters Visits Swazi-

land

2

Infection Prevention & Con-

trol Training: Emergency

Medical Services Unit

Equipped on Transmission

Prevention Measures

3

Pigg’s Peak Hospital Labora-

tory Mentorship: Applying

Quality Improvement Ap-

proaches to Achieving Ac-

creditation

4

International Nurse’s Day:

Providing Free Health Ser-

vices to the Public

5

GeneXpert Training: Build-

ing the Capacity of Lab Man-

agers on New Technologies

6

Injection Safety & Waste

Management Training: Im-

proving Injection Handling

7

TB Management in the Min-

ing Community: Dialogues

with Community Leaders

from Mamisa Chiefdom

8

Swaziland health Laboratory

Services Biosafety Training:

Strengthening Health and

Safety to Reach Accredita-

tion

10

Assessing Quality & Quanti-

ty of Sputum

11

Climbing the Corporate Lad-

der

12

Other Activities in April 14

Dr Samson Haumba, URC Swaziland Country Director


Like nature has assigned every parent the

responsibility to always check on their

young, the University Research CO., LLC

(URC) headquarters has not let up on this

role. URC-Swaziland was privileged to

have its parents from the United States

provide an opportunity for a visit to see

how the nest is holding, on the 21st of May

2014. The visit was by Dr Neeraj Kak,

URC Senior Vice President, PST and Ali-

sha Smith, Deputy Director of PST.

Excited about the visit the URC-Swaziland

team put up presentations to share on how

each project in the country is doing. A total

of 12 projects were shared each highlight-

ing some of the key innovations and re-

sults in USAID ASSIST project, CDC-URC

Lab project, Injection Safety and Waste

management project, In-service training

project, TB in the mines University Re-

search South Africa (URSA) project, Well-

ness Centre TB screening project, Moni-

toring and Evaluation support, Knowledge

Management and Advocacy Communica-

tion and Social Mobilization (ACSM) pro-

gress and finally Research.

This no doubt came in handy as it allowed

for resourceful inputs by the guests. The

overall impression that was picked up by

the end of all presentations was excite-

ment and pride, especially from the Coun-

try Director, Dr Samson Haumba who

seemed to be quite anxious at the begin-

ning of the update meeting.

Dr Kak congratulated the team for the

impressive work and success achieved by

the team. He added that he was confident

that the team works hard because of the

manner in which it responds to assign-

HEADQUARTERS VISITS SWAZILAND

Page 2 Volume 1, Issue 5

ments. “You are public health people and

have a strong drive inside each one of you

that moves you to work hard”, he highlight-

ed.

Words by Dr Kak brought smiles to the all

the staff present at the meeting and no

doubt left all of them motivated. Phrases

by Dr Kak, “If you are good you are asked

to do more” and “Success pushes you to

do more” managed to echo for weeks in

the passages of the URC-Swaziland of-

fice. These words encouraged the team

ensuring them that the added work load

meant that the team works hard and deliv-

ers commendable results.

URC Swaziland staff posing after the debriefing session with HQ colleagues, Dr Neeraj Kak, Senior Vice President, PST and Alisha Smith, Deputy Director of PST.


The Ministry of Health (MOH) has a pro-

gram known as the Emergency Prepared-

ness and Response Program (EPR)

which is responsible for responding to all

kinds of medical emergencies. The unit

under the program is referred to as the

Emergency Medical Services (EMS) Unit,

and its key responsibilities are to resusci-

tate and stabilize critically injured and ill

patients as well as transporting patients in

an ambulance.

Working in such demanding and critical

conditions each EMS staff is still expected

to take appropriate infection prevention

and control (IPC) measures. This is to

prevent any form of infectious transmis-

sion to and from themselves, exposing

themselves or the patients to any com-

municable diseases.

INFECTION PREVENTION AND CONTROL TRAINING: Emergency Medical Services Unit Equipped on Transmission Prevention

Measures


To strengthen these safe practices the

USAID ASSIST project held a two- day

training for two groups running from the

13th to the 15th of May 2014 at Esibayeni

Hotel in Manzini. A total of 43 paramed-

ics benefitted from the training done in

the form of lectures, discussion groups,

case studies, illustrations, visual demon-

strations and question and answer ses-

sions.

Sharing a few words, the EPR Pro-

gramme Manager, Masitsela Mhlanga

extended his appreciation for the needed

support from the University Research

CO., LLC (URC-Swaziland). As a way to

show their appreciation for the training,

Mhlanga further pledged the EPR Pro-

gramme to a zero tolerance infection

transmission policy.

The workshop focused on the following:

Standard Precautions ( Health Care waste Management, Hand

Wash, Disinfection, Linen management, Injection Safety, Proper use of PPE, Cleaning of environment)

Transmission based Precautions ( contact, airborne and droplet

precautions)

Post Exposure Prophylaxis ( PEP)

Handling and Transportation of an infectious patient / Prepared-

ness and Response in disease outbreaks

Cholera Disease

Nomathamsanqa Ndlovu– Mavuso , URC Infection Prevention & Control Technical Advisor, facilitating during the training.

Participants demonstrating how to ensure hand hygiene by using hand wash and

alcohol hand rub

Participant demonstrating proper use of Personal Protective Equipment, like the N95

respiratory mask

Team building sessions with the EMS team.


The month of March to May served as a

productive period for intense preparation

of the Pigg’s Peak (PPK) laboratory for

accreditation. The CDC URC- Lab project

Quality Assurance Laboratory Services

Advisor, Cinisile Ndlangamandla, has

been the key person providing mentor-

ship to the PPK laboratory to improve

quality management systems. With the

staff committed to seeing their laboratory

achieve the stars, implementing these

systems has been effective presenting a

noticeable and remarkable change in the

PPK laboratory.

The first action towards a quality assured

laboratory included correcting and im-

proving documentation systems and de-

veloping a quality manual. The filing sys-

tem has since been improved with 40

files opened as it was targeted in the

beginning. By the month of April 31 files

were updated filled with data and records,

leaving 9 which still needed to be filled.

The second action towards laboratory

accreditation focused on organizing the

personnel. This process involved identify-

ing and forming a quality team; develop-

ing reporting structure and job descrip-

tions guided by an SOP; updating per-

sonnel files; developing duty rosters and

the workstations; identifying management

calendars to improve personnel commu-

nication and finally ensuring that staff

meetings are held frequently also guided

by an SOP.

The next step worked on improving the

use and management of the laboratory

equipment. Files for all machinery in the

laboratory were opened including small

equipment such as centrifuges and tim-

ers. To further improve the management

of equipment an inventory list was devel-

oped. A system of uniquely identifying

equipment was developed and added in

the Quality manual.

Enforcing all pillars of quality manage-

ment, the quality team focused on pur-

chasing and inventory management as

the next step. This process involved iden-

tifying inventory focal person; rearranging

the storeroom and labeling of shelves;

stock count was done in preparation of

ordering; SOPs for stock management

were customized and finally stock counts

were identified making use of quality

indicator. Finally the quality team con-

ducted a customer survey to measure

how services provided by PPK lab meet

or surpass customer expectations and

needs.

PIGG’S PEAK HOSPITAL LABORATORY MENTORSHIP: Applying Quality Improvement Approaches to Achieving Accreditation


Quality Assurance Laboratory Services Advisor, Cinisile Ndlangamandla Pigg’s

Peak key mentor.

Updated data and records, filed and ar-ranged accordingly in shelves.

The PPK laboratory storeroom after it was arranged and labelled.

Labelling of all equipment in the PPK laboratory, Including the work areas.

Archiving room in the process of being ar-ranged. Shelves were cleared and labelled

clearly.


International Nurses Day (IND) is celebrat-

ed every year globally on the 12th of May

2014. This day was founded to commemo-

rate the birth anniversary of the Florence

Nightingale and to mark the nurses’ contri-

butions towards people’s health. The Swa-

ziland Nurses’ Association together with

the Hhohho RHMT did not want to be left

out in the celebrations, therefore requested

for support from the USAID ASSIST pro-

ject.

Together the team decided that they would

commemorate the day by giving back to

the community through providing free

health services to the public in the Mbaba-

ne City centre. In Swaziland the actually

commemoration took place on the 13th of

May at the Freedom Square Park where a

number of stalls were set up each provid-

ing a different health service. The services

ranged from HIV testing, basic medical

check-ups and TB screening a practise of

expertise within the organisation.

The commemoration of the day included

two activities, the first being a breakfast

meeting held at Emafini. This activity pro-

vided the opportunity for nurses to discuss

and interrogate some issues that have

overcome the medical field in the country

and still go unnoticed. The key issue which

was discussed was to try and identify the

root cause of the increasing maternal

deaths despite the fact that baby deliveries

are being conducted by skilled personnel.


INTERNATIONAL NURSE’S DAY: Providing Free Health Services to the Public

The second activity was an outdoor-do

which provided the University Research

CO., LLC (URC-Swaziland) team the op-

portunity to screen 67 people out of the 98

that visited the URC stall. The screening

process did not end there as the 30 that

screened positive were referred to the

Mbabane Government Hospital for further

management. By the end of the day 294

Behavioural Change Communication

(BCC) materials on basic facts of TB, the

TB smart card and MDR-TB were shared.

A view of the TB screen-ing stall at the Freedom Square Park, Mbabane.

Healthcare workers providing health infor-mation , TB screening and sharing some of the

BCC materials.

Healthcare workers that were present on the day providing health information on eye care.


to contribute in increasing capacity for full

utilization of the instrument and hence

improve quality services.

Objectives for the training were to ensure

that participants understand the following:

Understand and differentiate the

TB diagnostic platforms

Understand basic PCR technology

Understand GeneXpert technology

and Xpert MTB/Rif procedures

Correctly record, report and inter-

pret Xpert MTB/Rif results and

perform data management tasks

Troubleshoot potential problems

Perform Quality Assurance proce-

dures

At the end of the training, a training evalua-

tion form indicated that 63% of the partici-

pants felt that the GeneXpert training was

very good and effective. Beyond the evalu-

ation of the overall training, the test scores

attested to the success of the training. The

lowest recorded average score from the

pre-test was 40% which then improved

during the post-test to an average of 85%.


GENEXPERT TRAINING: Building the Capacity of Lab Managers on New Technologies

GeneXpert Mentor, Tandzile Zikalala facilitat-ing during practical sessions in a laboratory.

GeneXpert training in the past few years

has focused on solely laboratory staff

members who operate the machine and

perform the assay. In Swaziland this would

include trainings set for microscopists.

However, to increase efficiencies in labora-

tory and build competency among staff,

there is need to cross train laboratory man-

agers. This would be effective as it will

allow management to be capacitated on

the new technology, used by their staff on

a daily basis in the laboratories that they

manage.

On the 13th to the 15th of May 2014, a train-

ing was held at the Tums George, in Man-

zini. A total of 10 participants were trained

on the GeneXpert MTB/RIF assay, perfor-

mance, principles and maintenance. The

training enabled management to have the

necessary technical and practical skills and

knowledge to successfully utilize and over-

see the rollout of GeneXpert MTB/RIF

diagnostics at facility level. Well-trained

laboratory personnel with the competency

to perform Xpert MTB/RIF tests and trou-

bleshoot potential problems are expected

Pictures of practical session’s in the

lab with Laboratory Managers


On the 19th to 23rd of May, a training on

Injection Safety and Waste Management

(ISWM) was held targeting Infection Pre-

vention and Control (IPC) focal persons,

who in turn would become ISWM focal

persons. A total of 19 participants who

have direct experience and involvement

with handling injections and managing

healthcare waste were the main targets

during this workshop because of their

involvement and high volumes of injection

usage in the country.

The key objective of this training was to

impart knowledge on injection safety and

waste management persons on the skills

needed to execute the project within their

facilities, through support from The Univer-

sity Research CO., LLC (URC) to improve

on quality.

The training methods were designed to

have illustrative presentations which were

all followed by question, brainstorming

sessions, field visits and small group dis-

cussions. The field visits were to the two

main hospitals in the country, Raleigh

Fitkin Hospital (RFM) and the Mbabane

Government Hospital. Two teams were

assigned to each hospital where they

would spend four hours. This activity was


INJECTION SAFETY & WASTE MANAGEMENT TRAINING: Improving Injection Handling & Disposal Amongst High Usage

Groups

aimed at helping the focal persons to un-

derstand how to collect data for improve-

ment indicators and learn how to facilitate

a QI team meeting.

These methods were quite effective be-

cause by the end of the training it allowed

the participants to:

Be able to describe the broad con-

cepts of injection safety and health

care waste management

Be motivated to improve standards

of safe injection and waste man-

agement practices

Be able to define in simple terms

basic quality improvement con-

cepts

Be supported to draft action plans

for their facilities for the next 3-6

months

Group work sessions, which helped partici-pants understand the importance of team meetings, site visits and guided discussion

when working as a team.

Participants developing a work plan for facilities, making use of the Plan Do Study & Act (PDSA) cycle.

URC Injection Safety & Waste Manage-ment Advisor, Mandzisi Mkhontfo one of

the key facilitators during the training.


Volume 1, Issue 5 Page 8

TB MANAGEMENT IN THE MINING COMMUNITY: Dialogues with Community Leaders from Mamisa Chiefdom

Mamisa is a small chiefdom of the Mamba clan under

Sithobela Inkhundla in the Lowveld of Swaziland. A

majority of the community members from this location

earn their living through working in the mines in Malo-

ma and also in South Africa.

Cabrini Ministries Mission Clinic is the local facility for

this chiefdom and over the years has experienced a

number of health challenges with miners and ex-miners

from the chiefdom. Ex- miners (especially the ones

working in South Africa) who return home, due to ill-

ness, normally TB, usually out of fear of stigmatisation

do not seek health care and if they do they usually re-

port to the facility at advanced stages of the TB dis-

ease. Take for instance, in the previous year two pa-

tients from the chiefdom who were miners returned

home after falling ill, later on they were both diagnosed

with TB and initiated on TB treatment. Due to poor ad-

herence one of these patients ended up developing

drug resistant TB after which he died.

The National TB Control Program (NTCP) together with

the University Research CO., LLC (URC) as a support-

ing partner, and Cabrini Ministries Mission clinic felt it

was necessary to concentrate on these miners from the

chiefdom through conducting a dialogue with the tradi-

tional leaders in the chiefdom.

Traditional leaders open doors to community interven-

tions leading them to legitimacy and credibility. They

have a key role in social mobilisation of the community

to increase their efforts towards community interven-

tions. Traditional leaders are also influential and play a

fundamental role in changing the community norms

such that they become conducive and supportive for the

community intervention. The team therefore felt that it

was necessary to conduct a dialogue with the traditional

leaders from the chiefdom to undertake advocacy and

to ensure that the local traditional leaders take a leader-

ship role in improving the management of TB among

miners in the chiefdom.

Once the 17 community members as well as the 3 facili-

tators settled in a semi-circle the discussions were start-

ed off by addressing the challenges faced by the clinic

concerning TB management amongst miners. This dis-

cussion sparked an interest amongst each community

leader present in the forum, which suggested that the

leaders were oblivious to the implications paused by the

problem experienced in Mamisa Chiefdom. Amongst

the forum were members of the Inner Council (formerly

known in siSwati as ‘Libandla Lelincane’) sharing their

experience, testified that the challenges faced by the

clinic were due to stigmatisation attached to the disease

and that they were aware of some ex-miners who died

without accessing needed care because of the very

reasons.



Babe Mamba showing signs of how he was affected

by the stigmatization and discrimination went on to

say, “What hurt me the most was when they started

victimizing my children, saying that they were also a

hazard to their children. It soon became too much, I

could not take it I was ready to give up. Two months

after I had started my TB treatment I lost all hope and

stooped taking my medications for a week. I will for-

ever be grateful to my family for encouraging me to

continue taking my medication, had they not spurred

me on I might not even be here.

Babe Mamba expressed how excited and relieved he

was about the visit of the team and then he commit-

ted himself to driving for positive change in the com-

munity with issues pertaining to TB. Mamba pledged

to continue advocating for behavioural change which

will move the community to seek for health assis-

tance and empower the communities.

The open forum availed the platform for the partici-

pants to freely share their personal experiences. One

of the members, Babe Jabulani Mamba, willingly

shared his story as an ex-miner who suffered from

TB disease. Narrating his story he stated that after

returning home due to ill health he was faced with a

lot of challenges one of which was losing his source

of income. Babe Mamba related that shortly after-

wards he was diagnosed with TB, “This was very

challenging for me because apart from dealing with

my sickness I had to deal with stigmatization and

discrimination by my neighbours and other communi-

ty members. I felt like an outcast in my own commu-

nity, people I considered my friends changed and

soon became strangers, they would even go as far as

openly talk and laugh about my illness.”

The gossiping about Babe Mamba did not stop there

the community soon made allegations that the fact

that he was sick with TB was a clear indication that

he had AIDS and that he was going to die soon.

Babe Jabulani Mamba, a member of the inner-council and also an ex-miner openly sharing his story during the community dialogue.


With the Swaziland Health Laboratory

Services (SHLS) mission of getting accred-

ited, strengthening health and safety pro-

grams was has not been left out of the

checklist. First on the agenda for strength-

ening safety programs, Safety Officers

have been appointed by laboratory man-

gers. These officers are responsible for

implementing biosafety requirements

based on World Health Organization Bi-

osafety Manual, ISO 15189 and ISO 15190

in each laboratory.

However, these Safety Officers required

skills that can equip them to carry out their

duties professionally and effectively. It is

on this regard then that on the 5th to 9th of

May 2014, the University Research CO.,

LLC (URC-Swaziland) supporting the Min-

istry of Health held a Biosafety Training at

the George Hotel in Manzini targeting a

total of 21 participants from different facili-

ties around the country. The main objec-

tive for this training was to improve health

and safety in the laboratories and to equip

Safety Officers on Infection Prevention and

Control (IPC), first aid as well as fire safety

and biosafety. At the end of the training the

expected outcomes were to have well

trained and confident Safety Officers whom

can carry out their duties accordingly. The


SWAZILAND HEALTH LABORATORY SERVICES BIOSAFETY TRAINING: Strengthening Health and Safety to Reach Accreditation

training would also help improve

health and safety in laboratories

through complying to introduced safe-

ty standards.

The training included presentations

which were followed by question and

answer sessions. Beneficial for the

trainees were the team building ses-

sions which included practical activi-

ties related to the trainings. Some of

these activities included, creating a 6

inch tall man who can stand without

being supported from paper; first aid

basics level 1; and extinguishing fire.

Concluding remarks were shared by a

representative standing in for the

Chief Technologist whom highlighted

the importance of safety practices to

improve the quality of laboratories

and the safety of workers.

One of the training’s facilitators, URC Health and Safety Officer, Sanele Matsebula.

First Aid practicals.

Practical ses-sions on First Aid treatment during the training.

Outdoor activities which helped partici-pants apply what they learnt on distin-

guishing fire with the two types of extin-guishers.

Presentations on fire safety and waste manage-ment.


With the tips we shared last issue on best practices for collecting sputum, it is only appropriate not to leave that discussion hanging, but

share more knowledge nuggets about the quality and quantity of sputum. A lot can go wrong when collecting sputum resulting to the speci-

men being rejected. To avoid rejection pay close attention to the things you need to focus for ensured smooth sailing under the micro-

scope…

ASSESSING QUALITY & QUANTITY OF SPUTUM

Page 11 URC-SWAZILAND MONTHLY NEWSLETTER May 2014

KNOWLEDGE NUGGETS

The Sputum Specimen ‘Make Sures’ ...

Sputum specimen does not have any food particles Sputum is not washed down by saliva Sputum is not old (especially samples for culture/DST) Sputum container is completely sealed and there are no leaks Sputum is in sufficient volumes, should not be less

than 1 ml

The Request Form’s ‘Make Sures’ …

Carefully complete the request forms writing in a legible writing Include all patient details (e.g. patient name, date of birth, age) Include specimen origin (e.g. clinic name, ward) Form must be signed by nurse or doctor Avoid mismatching specimen and request form

Characteristics of a good sputum specimen

Minimum amounts of saliva

Minimum amounts of saliva

Mucoid/mucopurulent appearance

Optimal volume: 5ml-10ml

Minimum volume: 0.5ml

VISUALS ...

Good (Mucoid) Good (Purulent)

Good (Bloody) Poor (Thin & watery)


CLIMBING THE CORPORATE LADDER


SOCIAL CORNER

17 January 2011

PROJECT ACCOUNTANT

February 2012

Finance Manager

June 2014

Operations Manager

WONDER MTHETHWA ALEX KINTU

7th March 2012

Driver

25 April 2014

Community MDR-TB Linkages Assistance



SOCIAL CORNER

… For Laughs

LINDIWE MKHATSHWA

August 2006

HIV Testing & Counselling Country Coordinator

2009

HIV Testing &Counselling Technical Advisor

2011

Health Strengthening Systems Tech. Advisor

October 2013

Director of Health Strengthen-ing Systems Technical


UPCOMING ACTIVITIES IN JUNE:

External audits

Kick TB Campaign

Men’s health month

RHMT training

PSI Cough Officer training on TB manage-ment

Community mobilization: Shukuma Gogo

Phlebotomist Biosafety Training

TB/HIV Management training

Wellness Centre Healthcare Screening Re-port Sharing With Focal Persons

MDR-TB training

IST Quality Improvement

Model Clinics Collaborative Learning & Shar-ing Sessions

Intensive Case finding PHU Training

SWAMIWA Volunteers training

Pre-service Training for Graduating SANU

Nurses

RSSC Feedback Session & On-site QA/QI

Training

University Research CO., LLC (URC) 3rd Floor, North Wing, Building 1

Mbabane Office Park

Sozisa Road

P. O. Box 1404 Mbabane H100, Swaziland

Tel: (+268) 2404 7154/56/69

Fax: (+268) 2404 7199

Website: www.urc-chs.com

OTHER ACTIVITIES IN APRIL:

EDITORIAL TEAM

Jilly B. Motsa

Janet Ongole

Dr Marianne Calnan

Dr Samson Haumba

URC– SWAZILAND

Who Are We…

University Research CO., LLC (URC) is dedicated to improving the quality of

healthcare, social services and health education worldwide.

Mission

URC’s mission is to provide innovative, evidence– based solutions to

health and social challenges worldwide.

Expertise

In Swaziland, URC expands access to and improves the quality of services

addressing infectious diseases including HIV/AIDS, TB, and improving laborato-

ry quality management system

Approaches

URC focuses on finding ways to deliver proven approaches to health care prob-

lems, applying quality improvement (QI) methods and conducting research and

evaluation to tailor those approaches to various settings. Recognizing imple-

mentation barriers unique to each setting, we train local managers and service

providers to apply QI methods to strengthen health systems, integrate system

elements, and bring improvements to scale. URC also specializes in designing

health messages and materials to educate target audiences about improving

health behaviors.

Internal Lab Audits

TB NSP Finalization

GeneXpert training Clinicians

http://www.urc-chs.com/../../hiv/aids

http://www.urc-chs.com/../../tuberculosis

http://www.urc-chs.com/../../health_communication_and_behavior_change

http://www.urc-chs.com/quality_improvement

http://www.urc-chs.com/quality_improvement

http://www.urc-chs.com/research_and_evaluation

http://www.urc-chs.com/health_systems_strengthening

http://www.urc-chs.com/behavior_change_and_communication_2

Documents

URC-SWAZILAND MONTHLY NEWSLETTERNeeraj KaK , URC Senior Vice Presi-dent PST and Ms. Alisha Arthur Smith , Deputy Director of PST. Our colleagues provided technical support for on-going