Provincial TB Control Programs Reviewed

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Provincial TB Control Programs Reviewed

National TB Control Program (NTP) Islamabad organized its 2-day Inter-Provincial Meeting (IPM) recently at a hotel in Islamabad. The Meeting was attended by NTP/ PTP Managers, NTP Unit Heads, GF Objective Coordinators, M&E Staff, PRL Focal Persons, Technical and Implementing Partners of NTP.

The first day of the Meeting started with the welcome address by Dr. Ejaz Qadeer, National Manager-NTP. He also briefed the participants about the objectives of the meeting.

Dr. Munir Raisani, PTP Manager Baluchistan presented an overview on the progress of the Baluchistan province. He discussed issues and challenges which include lack of technical staff for M&E, POL for DTC, low per diem for inter & intra-district meetings, non availability of the PPD, DOTS implementation in the Fatima Jinnah Hospital and coordination with partners.

Dr. Obaid Hussain, PTP Manager Khyber Pakhtoonkwa shared the progress of province. According to him, the main issues in the province were implementation of MDR TB protocols, supply of pediatric drugs, nonpayment of the POL for DTC and claims of the PTO and NPOs, basic trainings of health care providers.

Dr. Darakshan Badar, PTP Manager Punjab presented the progress of the Punjab province. She said that the main challenges include unavailability out of the first line TB drugs, waiting list of MDR TB cases and high default rate in TCHs.

National Manager requested provincial Managers to ensure procurement of 50% drugs from the provincial resources. Dr. Amjad explained the MDR implementation and laboratory up gradation plan. Dr. Zarfishan and Dr. Amir updated in the laboratory issues of the PRL Lahore and Multan.

Dr. Ismat Ara, PTP Manager Sindh presented the progress of the Sindh province. She briefed about the challengues of POL re-imbursements for DTC & DLS, DOTS in the TCH, treatment of the non GLC patients and static case notification were main discussion points. National Manger urged on improving contact and suspect management to enhance case notification. Dr. Rafiq Khanani presented update on the laboratory status. The main issues were POL for the DLSs, weak M & E, rapid turnover of the lab Staff, need of BSL-3 lab, maintenance of equipments and certification used for culture and DST. 

Dr Adil Hameed, AJK Manager, presented the progress of AJK. PC-I for STP AJK, PPM implementation, establishment of SRL, recruitment against vacant posts and reimbursement of POL claimed by STP Manager were main discussion points. Dr Abdul Khaliq, Manager FATA, presented the progress of FATA. He thanks National Manager for support for Intra & Inter agency meetings. Dr Mobeen, Focal person from Gilgit Baltistan presented the progress in GB.

On the second day of the IPM, Dr. Abrar presented the analysis of the National data. He also discussed the discrepancies in the data and other related issues. Main issues discussed were incomplete suspect and contact information due to using old R & R tools, provision of timely data with hard copies and uniform population projection. After this a Technical Working Groups session was held. Following three issues were discussed in detail; HE phase out plan, electronic reporting system and module development. He also shared a province wise HE phase out plan. Dr. Abrar also shared the process of the development of curriculum for the medical graduates and nursing/ paramedical students and revision of national guidelines, doctor and paramedical training material. He informed that drafts of the curriculum for the medical graduates and nursing/ paramedical students have been shared with the provinces. The revision of the National guidelines, doctor and paramedical training material is in process.

National Manager said that NTP has two options for the Electronic reporting system; first one is WEB TB Surveillance developed by the WHO and second is incorporating Surveillance in the TB DMIS being developed by the Greenstar. All PTP managers, PTOs and NPOs were requested to provide comments on the modules so that these may be finalized.        

Dr. Ghauri, SPM PR unit, presented the progress update of the consolidated GF grant. He emphasized on achieving training targets, up gradation of BSL-2 & 3 labs and implementation of childhood TB were main challenges. He requested PTPs and SRs to ensure appropriate Inventory management and regular physical verification of assets at all levels.

Dr. Zia Dawar presented the progress on Round 8 and drug management issues which includes up-gradation / refurbishment of warehouses at different levels, timely availability of drug related data (R-8) and monitoring of R-8 activities were main discussion points.

Earlier, Dr. Ejaz Qadeer National Manager showed concerned on the lack of coordination of BDN with the program. He requested Mercy Corp to ensure proper coordination of BDN with the program. It was communicated to all partners that NTP will not accept any data or report unless it is endorsed by the respective provincial programs.

Consultative Meeting for GFATM Round-11

National TB Control Program (NTP) arranged a Consultative Meeting to discuss Round-11 on the second day of the Inter Provincial Meeting (IPM). Provincial TB Program Managers, NTP/ PTP Unit heads, and representatives from the technical and implementing partners participated in the Consultative meeting. The Executive Secretary for the Country Coordinating Mechanism (CCM) also attended.

Dr. Zarina Kauser, Executive Secretary CCM, briefed the participants about GFATM funding mechanism and requested Provincial Managers to actively participate in the consultative process for the GFATM Round 11 gap analysis and proposal development. She emphasized on development of the Provincial Strategic Plans for the TB Control.

Dr. Ejaz Qadeer presented the gap analysis of the program. He said that Children up to the age of 14 years account for more than 40% country population and all the risk factors for TB in children are highly prevalent in the country. Around 50,000 childhood TB cases exist in the country every year. 24,474 childhood TB cases were notified in 2010. NTP started childhood TB implementation in 42 districts with support of the GFATM Round 2 (2003-08). Currently childhood TB is being implemented in 30 districts and 27 tertiary care hospitals. NTP proposed expansion of childhood TB in remaining 110 districts. The package includes; training of health care workers, PPD for screening, childhood TB drugs and monitoring and evaluation.

TB is the leading cause of death among HIV/AIDS patients. Risk of mortality due to concurrent TB/HIV is twice as that of HIV or TB alone. The estimated incidence of TB in HIV-positive cases 6,700. NTP has started TB/ HIV co-infection activities with support of GFATM consolidated grant. TB/ HIV Coordinating Board has been established. 16 sentinel sites established for HIV screening among TB patients. 22,046 registered TB patients received testing and counseling for HIV in 2010 and 412 PLHIV were screened for TB symptoms in 2010. NTP needs to expand TB/ HIV services through establishing more TB/ HIV sentinel sites. The aim is to implementation of 3 Is for TB/ HIV; intensified cases finding, particularly in high risk HIV population, infection Control and isoniazid prophylaxis.

NTP proposed to implement Practical Approach to Lung (PAL) through the GFATM Round 11. PAL is a syndromic approach to the management of patients who attend primary health care services for respiratory symptoms. TB diagnosis can be part of the overall strategy for diagnosing lung diseases, through adopting the PAL. TB, ARI, asthma and chronic obstructive pulmonary disease can be managed through this integrated approach. The PAL strategy is used for Health System Strengthen in the Primary health Care setting.

NTP also proposed to start active case finding in the high risk group. The high risk group includes; prison inmates, internally displaced population, refugees and health care workers. The aim is to provide TB services through active case detection by using innovative technology (Gene Xpert, LED microscope).

2017-04-26T12:35:25+00:00