NTP-Seminar
The National TB Control Programme (NTP), Ministry of Health Islamabad organized its quarterly Inter Provincial Meeting from June 19-20, 2009 in order to identify the progress, strengths, weaknesses, opportunities and challenges faced by the programme in all the provinces including FATA, FANA and AJK and to discuss the future plans of the program.
Dr. Noor Ahmad Baloch, National Manager NTP chaired the two day meeting. The Provincial Managers, Mangers/Focal persons, Representatives of Directorates of AJK, FATA and FANA, Representatives of Provincial Laboratories, National Programme Officers, ACSM Coordinators, Sociologists, Partners from Private Sector and the whole National team was present.
Dr. Noor Ahmad Baloch in his welcome address briefed the participants about the over all TB situation in Pakistan. Tuberculosis poses a significant public health threat to developing countries like Pakistan. The Government of Pakistan and civil society are increasingly investing in control of this communicable yet curable disease. Every year almost 300,000 new TB patients add up to existing prevalent cases. National TB Control Program (NTP) and Provincial TB Control Programs (PTP) in collaboration with private sector implemented the New Stop TB Strategy and achieved 100 percent DOTS coverage in 2005.
Dr. Noor said that through sustained Commitment, Strengthening Partnership with Public and Private Sectors and introducing new initiatives, the program steadily improved case detection and treatment outcome for TB patients.
The first day of the meeting started with the presentations by the Provincial Managers, who highlighted the progress and achievements of the province and also the challenges they are facing for which thy need support from the National programme. Activity plans for next quarter were discussed and finalized for each province plus Azad Jammu & Kashmir and Northern Areas. These were followed by the presentations and discussions on national and provincial labs and Public Private Partnership initiatives. It was noted with satisfaction that there was no major deviation in the past quarter and targets set were met amicably.
Dr. Asmat Ara, Director, Provincial TB Control Programme Sindh through her presentation highlighted the efforts of Provincial TB Control Programme in eliminating TB. She further said that, in Sindh the defaulter patients are very high. There is no specific mechanism for tracing the defaulter patients. Thus the need is to establish peripheral labs at intermediate levels. The drug management issue is also very important and it must be given total attention.
Dr. Munir Ahmad Raisani, Manager, Provincial TB Control Program Balochistan on the occasion said that Balochistan is the province where 19 people live per square km. He said that when DOTS Strategy was started in 2001, there were only four district involved. Now in 2009, there are 30 districts where DOTS implementation is being done. Also there are now 137 diagnostic and treatment centres providing free of cost facilities to patients. Dr. Munir highlighted a significant trend that in Balochistan, females are suffering more than males i.e. 60 percent females and 40 percent males. Thus highlighting intensive social mobilizers are desired at the household level.
Dr. Darakhshan Badar, Manager, Provincial TB Control Program Punjab said that on World TB Day 2009, different activities were performed including campaigns through newspapers, advertisement, training of social mobilizers, ACSM material distribution and directory update. Field visit were also carried out by sociologists. She further informed the participants that in Punjab, 26 districts have achieved the 5 targets set for World TB Day. She said that Punjab is the largest province contributing to the burden of TB and this is the time to discuss the challenges and opportunities as we step into the next phase of GFATM Round 6 implementation.
Dr. Aafia, from Aga Khan University, Karachi gave insights on ‘Infection Control’ and said that the main objective is to prevent and control of transmission of Mycobacterium TB especially MDR in healthcare setting as well as community including households. She presented some cost efficient recommendations that could improve health facilities without any major change in the infrastructure.
She added that strategy to control TB transmission at these three levels is essential. The most important is administrative and managerial role which reduces infection exposure to health care workers and patients.
The second day of the meeting was started with by the most urgent issue of IDPs in NWFP. Dr. Abdul Ghafoor, Manager, Provincial TB Control Programme NWFP gave a presentation on the situation of IDPs in 5 districts of NWFP. He said that there is a lot of effort which the programme needs to do towards these people. Various camps for TB diagnostic and treatment have been set to support these homeless people. He also called for support from all the provinces in this regard. The National Manager NTP ensured full support to him and said that this is the point where the unity of the provinces may be seen.
Another major achievement of the National TB Control Programme is the development of a Brand for Tuberculosis. ACSM Unit members requested the National Managers and the Provincial Managers to inaugurate the brand. Mr. Nabeel and Ms. Maryam Jawaid of the ACSM unit presented the concept and strategy of the new brand. They said that there are more than 5,000 public and 2,000 private TB establishments providing diagnostic, treatment or both services at the same place. The largest number in order resides with Rural Health Center (RHC), Tehsil Head Quarter (THQ), District Head Quarter (DHQ) hospitals and upgraded Basic Health Units along with DOTS trained General Practitioners from the private sector. By large the flow and absorption of general and TB patients is a big challenge, a large number of TB patients end up in seeking health care from the public tertiary health care establishments as opposed to be absorbed by the primary and secondary health care establishments. Anecdotal evidence suggests that there has hardly been an effort to promote public health establishments offering quality diagnostic and treatment services in Pakistan. National TB Control Program and TGF partners envisage that the promotion of both public and private sectors in the urban, semi-urban and rural areas of Pakistan will contribute to retain TB clients at the desired health service delivery levels. In order to create uniformity in TB communications and services throughout the country and to minimize duplication and clutter of TB messages a TB brand is now developed. Both public and private sector TB establishments will be branded by using a single brand and installation of promotional boards at TB diagnostic and treatment centers. This is remarkable that public sector initiated development of a common brand on tuberculosis to promote Public-Private partnership. The brand name is
‘Together’ which is followed by the tag line “Hai Jeet Zindagi Ki”. The logo highlights a flower with eight petals signifying the eight months DOTS treatment process. The colour shifts from grey to green identifying the recovery process representing ‘Hope’. A branding guideline is also developed to set corporate identity standards. The guideline is to identify the usage of the brand under various situations.
Dr. Noor Ahmad Baloch in his concluding remarks emphasised the importance of improving quality of implementation at various levels. He appreciated the efforts of the National Provincial teams and partners from the private sector and said that with their support and whole hearted efforts of educating and informing the citizens against the myriad dangers posed by the TB rooted in ignorance we will meet success. He requested all the participants to join hands with NTP in speaking up loud and clear about TB and in eliminating the stigma and discrimination surrounding the epidemic and people living with TB. He further said that this meeting gives us wide opportunity to know what is going on in different provinces. It also gives a technical know-how and insight of new initiatives. The meeting does not only strengthen the program but also the complete health system.
In the end, Dr. Shahid Hanif, Deputy National Manager, National TB Control Program Islamabad presented vote of thanks.