pnct/ gf project/profamilia alliance › files › onthefly › content › module 3... ·...

14/05/2008 www.profamilia.org.do 1

PNCT/ GF Project/Profamilia AllianceProject evaluation at 3 years

PNCT Straightening

Dra. Ivelisse Acosta


Introduction• DR is among the top 10 Countries of TB burden in the

Americas region

• WHO estimates an incidence of 80 cases/100,000 hab./year.

• 1998 the country made the commitment to implement DOTS strategy

• 1999 the pilot project began in two provinces and the National District

• 2002 began the expansion phase

• 2003 Submit proposal to the GF. It is approved and in 2004 started the implementation. Profamilia is BP


IntroductionThis project has 4 objectives.

1. Expand and strengthen DOTS strategy in the 18 provinces of the country and in vulnerable population groups.

2. Strengthen and articulate the system of diagnosis in the intervention provinces and in vulnerable groups of the population.

3. Improve the technical capacity and management skills among health care workers working in TB control in the public and private sector.

4. Develop a social mobilization strategy for TB control in the 18 provinces and in vulnerable groups of the populations.


Global Fund Project – Provinces

• Duration: 5 years, 2004-2009

• 18 Provinces supported (San José de Ocoa, Pedernales, Independencia, Barahona, La Altagracia, Hato Mayor, El Seybo, Monte Cristi, Dajabón, Santiago Rodríguez, Valverde, Espaillat, Samaná, Salcedo, María T. Sánchez, La Vega, Sánchez Ramírez, Monseñor Nouel)

• 19 % TB cases 2006

• Favored population: 2,434,914 (27 %)


Coverage of the Strategy.Provinces GF. Dominican Republic. 2003-2007

0

100

200

300

400

500

600

0

10

20

30

40

50

60

70

80

90

100

No. EESS 77 298 420 451 520

% pob. Cubierta 16 71 85.5 86 90

2003 2004 2005 2006 2007

Source: TB National Program – SESPAS – RD

Num

ero

de E

ESS

%


More than 300 EESS (public y not public) with areas reorganized and equipped for DOTS implementation

2008 HEALTH RESEARCH IN THE AMERICAS IV: HIV/TB MODULE 3 - OPERATIONAL

PAGE 1


Patient SupportDeliver complementary food supply to 100% of the patients under treatment

Economic support for transportation to 100% of the MDR cases for TDO


Human Resources Training5,000 medical, nursing and lab professionals trained in topics regarding TB control program, DOTS strategy, Baciloscopy, Information systems, TB drugs, TB MDR and TB/HIV


RS Examined – RS Identified. Provinces FM. Domincan Republic. 2004-2007

0

5000

10000

15000

20000

25000

SRI 11407 17275 23077 23200

SR ex 9682 15173 20458 20984

2004 2005 2006 2007*

Num

ero

de S

R

85%

90%89%

88%

Source: TB National Program– SESPAS – RD14/05/2008 www.profamilia.org.do 10

Baciloscopy for diagnosis. Provinces GF. Dominican Republic. 2004-2007

0

10000

20000

30000

40000

50000

60000

70000

BK diag 24230 39500 58231 64548

2004 2005 2006 2007*

Source: TB National Program– SESPAS – RD

AFB

Num

ber


TB Incidence Rate AFB smear (+) GF ProvincesDominican Republic. 2004-2007

0

5

10

15

20

25

30

35

40

45

Incidencia TB P BK (+) 20 40 23 20.5

2004 2005 2006 2007*


Tas/

100 ,

000

hab. 754

486554

500


New TB AFB smear (+) cohort Treatment Regimen cases RHZE/4RH(3).GF Provinces. Dominican Republic. 2004-1 sem. 2006

0%

20%

40%

60%

80%

100%

Fallecidos 5.1 5 3.8

Fracasos 1 1.1 0

TSC 2.5 2.6 1.4

Abandonos 8.9 6.5 8

exito 82 83 86.8

2004 205 1 sem 2006


Evaluados 212541551


PAGE 2


MDR TB1. Implementation of the MDR TB management strategy (August 2006).

2. Adaptation of areas for TB MDR management (Hospital Juan P Pinaen San Cristóbal y Anti-TB de adultos calle Ana Valverde DN)

3. Personal training

4. Treatment initiation of 73 patients (until August 2007)

5. Adaptation of areas for TB MDR patients in Hospital Morillo King, in La Vega, with 9 beds, Expected to start in May 2008)



Social Mobilization• Social Mobilization strategy implementation (March 2006). • 18 provinces with social mobilization activities through 6 NGOs (August 2007)• 2,085 promotores trained • 726,550 people reached through social mobilization activities

(workshops, home visits, large group gatherings) • Establishment of Association of people affected by and sick with TB• Establishment of 5 TB support committees in the provinces

(Barahona, Hato Mayor, El Seybo, La Altagracia y San José de Ocoa)


14/05/2008 www.profamilia.org.do 17 14/05/2008 www.profamilia.org.do 18


PAGE 3


Challenges for the next 2 years• Continue the political commitment

• Support and consolidate DOTS strategy with quality(supervision and training)

• Strength lab infrastructure to improve TB diagnosis

• Expand TB MDR strategy

• Collaboration for TB/HIV control

• Support binational agenda initiative

• Expand social mobilization strategy to all municipalities and integrate it in the groups against TB


Thanks!


PAGE 4

pnct/ gf project/profamilia alliance › files › onthefly › content › module 3... ·...

Documents