Community members, healthcare workers, TB Champions, county officials, and development partners gathered on 8 May, 2026 at Zael Conference Hall in Mavoko Sub County, Machakos County for a structured community dialogue under the COMBAT DR-TB Project. Organized by the Network of TB Champions Kenya (NTBC-K) with support from KELIN. The forum aimed to identify bottlenecks across the DR-TB care cascade and generate community-driven solutions.
Voices from the Community
Participants demonstrated a strong understanding of DR-TB transmission and the distinction between drug-sensitive and drug-resistant TB, creating space for honest, experience-driven discussion. DR-TB clients shared powerful testimonies, including one client who described the emotional toll of visible skin discoloration as a medication side effect, and another who spoke of being shunned by neighbors after his diagnosis was discovered. A third client raised concerns about delayed access to treatment support, forcing him to borrow transport fare for multiple facility visits.
“People avoided me. Even my close friends stopped visiting. The medication changed how I look, but the loneliness was harder than the sickness.”
— DR-TB client, Machakos County Community Dialogue
“I had to choose between buying food and paying fare to the hospital. Without the TB Champion checking on me, I would have given up.”
— DR-TB client, Machakos County
Community Health Promoters also voiced concerns about homelessness among DR-TB patients, noting that some individuals under their watch had no fixed address, making daily observation and contact tracing nearly impossible.
“We cannot trace what we cannot find. Homeless patients move constantly. We need a different approach for them.”
— Community Health Promoter, Machakos County
Gaps Identified
Participants identified several interconnected challenges affecting DR-TB outcomes in Machakos County, including supply chain weaknesses such as recurring stock-outs of DR-TB commodities and paediatric TB Preventive Therapy (TPT), as acknowledged by County TB Coordinator Dr. Johannes Ndambuki. Persistent stigma and discrimination continue to deter early care-seeking and treatment adherence, while cultural misconceptions drive reliance on herbal remedies instead of scientific treatment. Homelessness among DR-TB patients was highlighted as complicating patient follow-up and contact tracing. Additionally, poor treatment adherence remains a major concern, linked to alcohol and substance use, delayed healthcare seeking behavior, and inadequate psychosocial support.
Technical Inputs & Innovations
Machakos County TB, Leprosy and Lung Health Coordinator Dr. Ndambuki emphasized that community participation is critical to ending TB by 2030 and noted ongoing county efforts to strengthen clinician capacity through Continuous Medical Education (CMEs). However, he reiterated that supply chain weaknesses remain a major barrier.
Healthcare facilitators educated participants on the oral short-term DR-TB regimen (BPaLM), proper sputum collection, nutrition, ventilation, and Directly Observed Therapy (DOT). A technical session by KELIN highlighted Near Point-of-Care (NPOC) diagnostic technologies, which reduce turnaround times and strengthen linkage to treatment.
Key Recommendations
Participants issued several actionable recommendations to improve DR-TB outcomes in Machakos County, including strengthening community awareness campaigns to address stigma, misinformation, and harmful cultural beliefs; enhancing collaboration between healthcare workers, TB Champions, and Community Health Promoters; improving patient follow-up systems, especially for homeless and vulnerable patients; scaling up nutritional and transport support for DR-TB patients in need; and reinforcing supply chain systems at both county and national levels to prevent stock-outs of DR-TB medicines, diagnostics, and paediatric TPT.
Next Steps
Findings and recommendations from the dialogue will inform county-level DR-TB microplanning and be shared with the National TB & Leprosy Control Programme for policy consideration. A follow-up dialogue is scheduled for Q3 2026 to review progress.
Conclusion
The dialogue concluded with renewed stakeholder commitment to reduce stigma, strengthen treatment adherence, and improve access to patient-centered DR-TB services across Machakos County. Organizers emphasized that sustained community engagement and accountability mechanisms remain essential to accelerating progress toward ending TB by 2030.
This activity is part of the COMBAT DR-TB Project, implemented with support from Unitaid – a global health agency driving innovation to prevent, diagnose, and treat TB more effectively, affordably, and equitably.
Compiled by: Joyce Ngetuny & Irene Mbacha- Project Officers
