Docstoc

Jordan

Document Sample
Jordan Powered By Docstoc
					Regional Advocacy, Communication and Social
     Mobilization Planning Workshop for
            Tuberculosis Control


       Amman, Jordan 13-17 April 2008
     Regional Advocacy, Communication and Social
Mobilization Planning Workshop for Tuberculosis Control

               Amman, Jordan 13-17 April 2008
•Population: 5.6 million


•Surface area: 89,000 Sq.Km
                                           Syria
•Middle income country: 1,208 JD                          Iraq
(1,700 US $)

•Demographic transition: life
expectancy: 71.5 years
• Epidemiologic transition:
- Infant Mortality rate: 22/1000
     live births
-Decrease in communicable diseases,
including TB.
 Increase in chronic diseases, including           Saudi Arabia
chronic respiratory diseases (CRD) .
  Various Health system in Jordan
           (1999 – 2003)
Country Health Data                 2001   2002    2003


Number of Hospitals                  91      95      97
Hospital Beds                       8982    9383    9743
Ministry of Health                  3357    3462    3587
Royal Medical Services              1760    1791    1801
Jordan University Hospital           517    531     540
King Abdullah University Hospital     -     197     283
Private Sector                      3348    3402    3532
                Health Centers of MOH
Type of Center                            2001   2002   2003

Comprehensive Health Centers               47     53     52

Primary Health Centers                     338    336    340

Peripheral Health Centers                  258    258    259

Maternity and Child Health Care Centers    351    351    353

Chest Diseases Centers                     11     11     12
Dental Clinic                              240    247    250
             TB control in Jordan
   Low TB burden: in 2007:
     * 333 TB cases (all types) (in addition to 150 cases
     Among foreigners transferred out)
     * Incidence (all TB types): 6 / 100,000 population
     * SS+ incidence: 1.8/100,000 population
     * ARI : 0.04%
   TB incidence decreasing: 13/100 000 in 1992 
    6 in 2007
   100% population DOTS coverage (1998)
   Case Detection Rate: 63% (2005)
   Success Rate: 87% (2006)
   Prevalence of MDR :5% (2006)
structure of TB control programme
             in Jordan
    Structure of the Tuberculosis
          Control in Jordan
    The National TB (NTP) in Jordan is a vertical
    Programme

   At the Central level the Chest Disease
    Division (in Amman City), responsible for
    Tuberculosis control program throughout
    the country including supplying medicines.
    The main role is planning, coordination and
    supervision of the control activities.

   At the peripheral level, there are 12 chest
    centers covering the whole country.
Distribution of Diagnostic TB Centers
              in Jordan
                      Goal
   Reduce mortality and morbidity and
    transmission of tuberculosis, while preventing
    drug resistance, until tuberculosis no longer
    poses a threat to public health, and achieve
    the Millennium Development Goals (Goal 6,
    Target 8) by 2015
                 OBJECTIVES
   Improve TB care for vulnerable populations
    in Jordan (Refugees, poor, mobile) .

   Improve tuberculosis care for people
    suffering from multi-drug resistant
    tuberculosis and TB/HIV in Jordan

   Improve general tuberculosis care
Trends over time of the incidence of TB
 in Jordan (per 100,000 pop. per year)
                                35

                                30                         28.9
                                                27.8
   IncidenceRate /100,000 pop




                                25                                     25
                                                                              23.2
                                                                  21             21.1
                                20                                              19.2    18.9

                                        14.8                                                   16
                                15             14                                                   14             12
                                                    12.8                                                   13
                                                                                                                         11
                                                                                                11.5
                                10                                                                         10     10.5          8.3
                                                                                                                          9                                              6.4
                                                                                                                                              6.4       5.8    6
                                                                                                                                 7.8                                           6
                                                                                                                                        6.2         6
                                 5                                                                                                                                 5.3


                                 0
                                   78


                                           80


                                                      82


                                                             84


                                                                         86


                                                                                  88


                                                                                          90


                                                                                                      92


                                                                                                             94


                                                                                                                    96


                                                                                                                           98


                                                                                                                                   00


                                                                                                                                           02


                                                                                                                                                          04


                                                                                                                                                                 06
                                 19


                                         19


                                                    19


                                                           19


                                                                       19


                                                                                19


                                                                                        19


                                                                                                    19


                                                                                                           19


                                                                                                                  19


                                                                                                                         19


                                                                                                                                 20


                                                                                                                                         20


                                                                                                                                                        20


                                                                                                                                                               20
                        Year
              Trends over time of the number of
                   new TB cases in Jordan
                  400


                  350

                                                    Pulmonary TB
                  300
                                                    Extra-pulmonary
Number TB Cases




                                                    TB
                  250
                                                    SS+ Pulmonary

                  200                               Total TB


                  150


                  100


                  50


                    0
                        2002   2004   2006   Year
              CHALLENGES
   Low Detection Rate: TB case detection
    for new sputum smear positive
    pulmonary TB cases in 2005 was 63%
    (target of 70%);

   MDR TB is increasing among Jordanians
    (2% in 2004 , 5% in 2006)
  ACSM ACTIVITIES


JOR506 G02-T/NTP-MOH
           COMPONENT 1: PURSUING, OPTIMIZING AND SUSTAINING QUALITY DOTS


       Activity                       Indic   Budget   Funding
N.                                    ator    (in USD) source

1.1 POLITICAL COMMITMENT WITH INCREASED AND SUSTAINED FINANCING:

     NTP will initiate one meeting per
     year headed by the Ministry of
     Health and members of a higher
     policy forum or a National board,   One meeting is            WHO
     to plan and monitor activities of   held yearly               MOH
     the NTP and to strengthen
     commitment and financial
     sustainability

     NTP will play a key role in
     activating CCM to assess needs      Regular meetings
     and requirements and to review      every three              GFATM
     and revise action plans for TB      months
     control in Jordan.

     At Governorate levels, TB
                                         M&E Committees            WHO
     coordinators will reactivate M&E
                                         meet biannually           MOH
     committees
            COMPONENT III: ENGAGE ALL CARE PROVIDERS


N.   Activity                          Indicator          Funding source

3.1 PUBLIC-PUBLIC, AND PUBLIC-PRIVATE (PPM) APPROACHES:
                                                        GFATM
Setting up a database for all Database
stakeholders and focal persons Established
in all areas entitled to control
and manage TB cases.
                                                        GFATM
Forming a steering committee Steering
to plan and implement PPM Committee
strategy  and     to   build Formulated
commitment.
                                                        GFATM
Developing the PPM Strategy          PPM strategy
                                     Developed and
                                     printed
Train all TB care providers in all
areas responsible on TB case         No.of TB care providers trained
management..
 COMPONENT III: ENGAGE ALL CARE
 PROVIDERS
N.      Activity                                       Indicator

3.1.5   Supervisory visits to all TB control clinics   No.   of    Visits
                                                         Conducted
3.1.6   Ensuring supply of anti-TB drugs to clinics    All clinics dealing
           dealing with TB cases.                         with TB cases
                                                          provided     with
                                                          anti-TB drugs
3.1.7   Printing all guidelines and revised R&R Guideline          and
           formats needed for the TB-Care provider to revised     R&R
           ensure adherence to guidelines.            format developed
                                                      and printed
3.1.8   Increase awareness of medical Schools’ staff   No.    of     medical
           and nursing schools’ staff about TB           Schools’ staff and
           problem through training.                     nursing schools’
                                                         staff trained
  COMPONENT III: ENGAGE ALL CARE
  PROVIDERS
N.   Activity                          Indicator
3.1. Increase awareness of medical     No. of medical
  9    Schools’ students and nursing    Schools’
       schools’ students about TB       students and
       problem through training         nursing
                                        schools’
                                        students
                                        trained
 INTERNATIONAL STANDARDS
     FOR TB CARE (ISTC)
To translate and disseminate ISTC among ISTC
  syndicate of physicians, private sector  translated,
  directorate, not for profit hospital and printed and
  policlinics, and NGOs.                   distributed
Organize lectures and congress for all           No.           of
  stakeholders about the international standards   stakeholder
  for TB care.                                     attended
                                                   lectures
Measuring the impact of adherence to the Measurements
  standards on quality of care and patient         tools settled
  satisfaction.
  COMPONENT IV: EMPOWER PEOPLE WITH
        TB, AND COMMUNITIES
Activity                                            Indicator


NTP social Workers organize focus group discussion Established or not
  with patients on patients’ charter
Orientation meetings with all policy makers         Proportion. of attendance

Establish a support Group for TB patients and their Support Group Established
   families in collaboration with Jordanian Anti TB
   Association (JATA)
Conducting KAP studies                              KAP study conducted
TOT for health care providers                       No.      of care   providers
                                                          trained
Conducting a campaign                               No.     of    governorate
                                                       involved
                                                    No. of seminars conducted
 COMPONENT IV: EMPOWER PEOPLE WITH
       TB, AND COMMUNITIES
Production of health education materials (TV spots, No.     of     materials
   Radio broadcasting, booklets, posters, etc…) For     developed by type.
   different target groups.                         No.     of    sites   of
                                                        distribution.
School student awareness raising activities           No.        of    schools
                                                            conducted
                                                            awareness raising
                                                            activities
Celebrating the World TB day                          No. of sectors involved



Creating and updating a website of NTP Jordan         Website created and
                                                        updated
   Community participation in TB Care:
Setting up a complete database about national and        Database is Done
   international NGOs.
Orientation meeting with all NGOs focal persons to No    of    meetings
   increase awareness about TB problem and to build   conducted
   commitment
Integrating international NGOs in fund raising and No of conferences
    sharing in TB control through materials, conferences shared by NGOs,
    and research.                                        No of Materials
Orientation meeting with       community     leaders   to No. of meetings
   participate in TB fight                                  conducted
Empower community volunteers to support TB patients      No      of Volunteers
                                                              supporting NTP
Integrating the women lead NGOS to support the NTP.      No.. of women lead
                                                           NGOs involved n
                                                           NTP activities
        PATIENTS’ CHARTER FOR TUBERCULOSIS CARE:


Forming a task force to set up a national Task         force
  document for TB patients’ rights.         formulated


Setting and printing a poster and booklets Posters and booklets
  for TB rights                              printed


Disseminating the poster and booklets to Posters and booklets
  all chest facilities, all partners and   disseminated
  private clinics.
            ENABLE AND PROMOTE RESEARCH

Activity                                                Indicator




NTP in collaboration with WHO and other partners
  identify the main research areas for next five year

Conducting two studies per year                         Number of
                                                          studies
                                                          accompli
                                                          shed
   Monitoring and Evaluation (M&E)
               activities
                       Key Indicators                             Baseline




Establishment of M&E task force within the National TB
   program

Training and refresher training workshops for 45 social workers
   and home visitors related to TB
 Upgrading of Surveillance and strengthening M&E
                      system

                    Key Indicators                         Baseline



Training for Governorate TB coordinators on surveillance
   including data verification and quality in terms of
   completeness, accuracy and timeliness through
   electronic templates in 3 days duration workshops for
   40 staff.
NTP will supply the TB management units (TBMU) with
  computers and printers resources and other
  equipments (CDs, flash memories …..etc needed for
  ENRS implementation based on needs
  ACSM Contribution to National TB
  Control
National Objectives   Related Interventions

1- Improve TB care    Empower community volunteers to support TB
                        Patients through establishment of volunteer
   for vulnerable       network between the NTP and all NGOs
   populations in       nationwide.
   Jordan             Orientation meetings (1 every quarter) with Concerned
                         NGOs focal persons, influential leaders to increase
                         awareness about TB problem and to build
                         commitment
                      Outreach educational sessions to increase
                         awareness about TB
                      Production of health education materials
                         (Broadcasting, booklets, posters, etc…) For
                         different target groups.
                      Educational sessions conducted to
                      increase awareness on TB among students schools
  ACSM Contribution to National TB
  Control
National Objectives   Related Interventions

1- Improve TB care    Conducting KAP studies to
   for vulnerable
   populations in      Assess the knowledge,
   Jordan              attitude and perception of
                       the population regarding
                       TB;
ACSM Contribution to National TB
            Control
2- Improve              Developing and printing
   tuberculosis         TB/HIV guideline
care for people
suffering from multi-
drug resistant
tuberculosis and
TB/HIV in Jordan
 ACSM Contribution to National TB
             Control
3- Improve       NTP will play a key role in activating TB
                 coordinators to assess needs requirements
  general        and to review action plans for TB and to
  tuberculosis   reactivate M&E strategy (meeting on
                 quarterly basis).
  care
                 Training and refresher training workshops
                 for 45 social workers and home visitors
                 related to TB
                 Translate and disseminate International
                 Standards for Tuberculosis Care (ISTC)
                 among syndicate of physicians, private
                 sector, not for profit hospital and policlinics,
                 and NGOs.
                 NTP social Workers organize 8 focus group
                 discussion with patients on patients’ charter
 ACSM Contribution to National TB
             Control
3- Improve       Conducting a study on Case
                   finding among tuberculosis
  general          suspects and barriers
  tuberculosis     interfering with their timely
  care             healthcare in mid and
                   northern Jordan
                CONCLUSIONS
   Successful TB
    Elimination

                                    Highest
                                     level of            Support of
                                                          concerned
                                    political           international
                                                        organization

  Reaching                          support
Global Target      Community
                   compliance
                                                Support and
                                 Support of     collaboration of
                                   other        governorate
                                 concerned      health
                                departments     authorities
                                 & sectors
Thank you

				
DOCUMENT INFO