Tuberculosis presentation slide PowerPoint
- 1. Partnering with Communities : an approach to planning and implementation Elena McEwan Senior Technical Adviser Catholic Relief Services
- 2. 1. Pursue high-quality DOTS expansion and enhancement a. Secure political commitment, with adequate and sustained financing b. Ensure early case detection, and diagnosis through quality-assured bacteriology c. Provide standardized treatment with supervision, and patient support d. Ensure effective drug supply and management e. Monitor and evaluate performance and impact 2. Address TB-HIV, MDR-TB, and the needs of poor and vulnerable populations a. Scale-up collaborative TB/HIV activities b. Scale-up prevention and management of multidrug-resistant TB (MDR-TB) c. Address the needs of TB contacts, and of poor and vulnerable populations, including women, children, prisoners, refugees, migrants and ethnic minorities 3. Contribute to health system strengthening based on primary health care a. Help improve health policies, human resource development, financing, supplies, service delivery and information b. Strengthen infection control in health services, other congregate settings and households c. Upgrade laboratory networks, and implement the Practical Approach to Lung Health (PAL) d. Adapt successful approaches from other fields and sectors, and foster action on the social determinants of health 4. Engage all care providers a. Involve all public, voluntary, corporate and private providers through Public-Private Mix (PPM) approaches b. Promote use of the International Standards for TB Care (ISTC) 5. Empower people with TB, and communities through partnership a. Pursue advocacy, communication and social mobilization b. Foster community participation in TB care c. Promote use of the Patients' Charter for TB Care 6. Enable and promote research a. Conduct programme-based operational research, and introduce new tools into practice b. Advocate for and participate in research to develop new diagnostics, drugs and vaccines WHO Stop TB Strategy
- 3. CRS Guiding Principles тАв Community involvement values: тАв The dignity of each person at the centre. тАв At the origin of rights and responsibilities тАв A common good which will benefit all its members. тАв The empowerment of people who recognize their rights and assume responsibility for their own health has at least two fundamental dimensions: solidarity and subsidiarity.
- 4. Characteristics of effective models тАв Patients and communities involved from the outset in planning, implementation and evaluation of TB control efforts - including joint periodic reviews. тАв National and local health services worked to establish a partnership with the society. тАв Clear definition of roles and responsibilities of all partners involved. тАв Issues of communication and social mobilization addressed тАв There was a commitment by all partners to pool resources, follow guidelines and ensure improved awareness and quality of care. тАв Motivation has often been solidly rooted in personal and community values.
- 5. Notable characteristics of TB-ACSM programming тАв Engagement of diverse stakeholders in TB тАв Direct outreach to communities and vulnerable populations; тАв An emphasis on effective IEC strategies and appropriate materials; тАв Patient-centered approaches in service delivery; тАв Impact: ACSM approaches improved early case detection and treatment adherence, combat stigma and discrimination against TB patients, empower people affected by TB and mobilize political commitment and resources to address TB.
- 6. Increase in access to microscopy in a conflict setting- Philippines Situation: тАв Maguindanao Province has achieved case detection and treatment success rates that are close to the national average. тАв Some of the barriers : тАУ Outdated technical competency тАУ Irregular supervision and monitoring тАУ Poor access due to the ongoing conflict, lack of health personnel and geographic terrain and тАУ Limited community knowledge on the cause and transmission of the disease and stigma related to TB тАв The Maguindanao Tuberculosis Control Project a four-year project CRS in partnership with Integrated Provincial Health Office (IPHO)-Maguindanao,
- 7. ACSM Intervention The ACSM strategy is aimed to focus on key behaviors at different levels to improve the quality of TB preventive and curative services тАв Behavior change communication for health staff, тАв Development of an ACSM plan: тАв Reactivation of 11 local health boards to plan and solicit for greater political support for TB, and тАв Quick Disaster Response Team, health personnel were dispatched on site to assess, and respond to the emergency situation brought about by the escalation of armed conflict. тАв Community based TB care services were especially useful for those who could not travel due to security risks.
- 8. Innovation one: Improving access with Barangay Health Workers role Training in DOTS, and sputum collection & smearing тАУ DOTS: 2-day тАУ Sputum Collection & smearing: 5- day training (didactic 2 days; practicum 3 days) тАУ Monthly monitoring Major roles: 1. Collecting & smearing тАУ Transport slides тАУ Recording 2. As treatment partner
- 9. Innovation two: Microscopists on Wheels Private transport group (mostly single motorcycle) plying at remotest area volunteered to provide services for TB control & prevention. тАУ Free or discounted fare for TB patients & symptomatic тАУ Free transport of slides or specimen тАУ Promote TB awareness & free services of RHU Process used: тАУ RHU recommended transport group from their area тАУ Gen. orientation & core group formation at provincial level and follow-up at RHU level.
- 10. Innovation three TB Club Serves as a peer-support group to ensure patientтАЩs treatment compliance & reduce stigma. тАв Activities: тАУ sharing and encouragement among members to motivate adherence to treatment regimen тАУ cured patients as peers тАУ contact tracing тАУ case referral тАв Membership: voluntary тАв Structure: flexible, formally loose-group.
- 11. Innovation four: Networking with Muslim Religious Leaders (MRLs) тАв 135 Muslim Religious Leaders (MRL) pledged to take part in the fight against TB in their respective Mosque before a formal worship takes place. тАв Giving TB information to the Muslim Ummah (community) Process: тАв Reactivate the Local Health Boards (LHBs) in most municipalities тАв The RHU team initiated advocacy conferences and meetings with Local Chief Executives (LCEs to increase awareness) тАв The LHBs are expected to solicit support from LCEs in the form of ordinances and resolutions in order to strengthen the TB program. :
- 12. Treatment outcomes- IPHO Integrated Provincial Health Office 2004-2007 Year % Cured % Defaulters 2004 72 6 2005 70 5 2006 78 4 2007 79 5
- 13. Stigma indicators Indicator Baseline (%) 2006 Final (%) 2009 % of people who thinks that avoiding a person with TB symptoms is correct 58 44 % of people who sympathize with a person sick with TB 18 51 % of people who said that a person sick with TB is treated like any normal person 32 69
Editor's Notes
- #7: The project has factored in the volatility of the security situation affected by the protracted armed struggle of Moro separatist groups. In an upsurge of conflict, the project utilizes the existing QDRT (Quick Disaster Response Team) mechanism of IPHO-Maguindanao to track patients and defaulters. QDRT is a team composed of health personnel who are dispatched on site to assess, and respond to the emergency situation brought about by the escalation of armed conflict. The project conducted rapid assessment of TB program during displacements in some communities of Maguindanao, and has since worked on the recommendations of tracking the patients in the evacuation centers and those that are house-based to ensure treatment compliance.
- #10: .