Presentation CCM - CCMPakistan

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Presentation CCM - CCMPakistan Powered By Docstoc
					Global Fund supported TB Projects

  National TB Control Program Pakistan
       The Principal Recipient for
             Round-6, 8 & 9
              Presentation by:
       Dr. Abdul Khalique Ghauri
           Senior Project Manager
           Global Fund Grants NTP
   Round-6
Progress Update
                                                          Targets Results
 Objective                   Indicators                    up to   up to     %
                                                           P-11    P-11
             No. of new smear positive cases detected.
                                                          80,849   80,099   99%
             (National Number)
 All SDAs
             No. of new smear positive pulmonary TB
                                                          68,410   70,070   102%
             cases successfully treated. (National No.)
             Number of peripheral Labs supported for
                                                            712     697     98%
             QA diagnosis
 1. Quality  Percentage / Number of intermediate labs
                                                            112     108     96%
  Assured    (ILL) under EQA
Bacteriology Number of Lab staff trained.                  1,393   1,225    88%
             %age & No. of National/Provincial labs
                                                             9       2      22%
             performing quality assured culture & DST
             No. and % of new TB cases (all forms) that
  2.Engage                                                 6,060   10,704 177%
             are difficult-to-diagnose detected at TCHs
Tertiary Care
Hospitals in Number of Child hood TB cases managed
   DOTS                                                    3,333   3,585    108%
              according to national guidelines
                                                          Targets   Results
   Objective                   Indicators                  up to     up to     %
                                                           P-11      P-11

                No. of registered TB Patients receiving
                testing and counseling for HIV after      20,736    20,714    100%
                giving consent
 4. TB-HIV & No. of PLWHA receiving testing,
   MDR-TB    counseling and treatment for HIV are          326       390      120%
             screened for TB symptoms
                No. of Lab confirmed MDR-TB patients
                                                            80       200      250%
                enrolled in 2nd line Anti-TB treatment
                 Number of NTP/Health Managers
                                                           584       469      80%
                 trained in Program Management
                 No. of Doctors trained from diagnostic
5. To Strengthen                                           5,660     4,947    87%
                 and treatment centers
    NTP for
    effective    No. of Paramedics trained from
                                                           8,660     6,451    74%
    Program      diagnostic & treatment centers
Implementation No. of Diagnostic Centers submitting
               timely reports on quarterly basis           1,166     1,082    93%
               according to national guidelines.
    Financial Summary GF R-6

 Budget      Utilization   Cumulative Cumulative
  P-11          P-11         Budget      Exp
 (US $)        (US $)        (US $)     (US $)




1.54 million 0.84 million 14.5 million   9.8 million
                  To-date
 R-6 & R-9 Grants have been Consolidated and
  formally signed in November 2010
 Current reporting quarter (Jul-Sep 10) is the
  last quarter for GF R-6
 Some of the activities which were left over
  have been carried forward in Consolidated
  Grant
 2nd order for Second Line Drugs for MDR-TB
  patients has been raised
   Round-8
Progress Update
                                                      Targets   Results
  SDA                    Indicators                    (P-4)     (P-4)
                                                                           %

  Objective 1: High quality DOTS expansion and enhancement
High      Number of New Smear Positive TB patients
Quality   reported to the national health authority
                                                       80,849    80,099   99%
DOTS      (National Number) (cumulative per
          calendar year)
High      Number of New Smear Positive TB patients
Quality   reported to the national health authority    26,950    23,505   87%
DOTS      (National Number) (non-cumulative)
High      Number of New Smear Positive TB patients
Quality   reported to the national health authority
                                                       12,936    10,193   79%
DOTS      through Private sector (National Number)
          (cumulative per calendar year)
High      Number of New Smear Positive TB cases
Quality   Successfully Treated, (National Number)      68,410    70,070   102%
DOTS      (cumulative per calendar year)
High      Number of New Smear Positive TB cases
Quality   Successfully Treated, (National Number)
DOTS      (non-cumulative)                             22,803    21,665   95%
                                                           Targets Results
       SDA                      Indicators                  (P-4)   (P-4)
                                                                                %
High Quality         Number of New Smear Positive TB
DOTS                 cases Successfully Treated among
                     those managed in the Private Sector    10,946   8,187     75%
                     (National Number) (cumulative per
                     calendar year)
Procurement &        Number and % of districts reporting
Supply               no stock out of first line anti-TB
Management (First    drugs on the last day of quarter        134      134      100%
Line Drugs)

HSS: Medical         Number of warehouses refurbished
Products, Vaccines   at national/ provincial/ regional/
and Technology       district level for the appropriate      48        1       2%
                     drug storage


         Objective 2. Health Systems Strengthening (HSS)
Monitoring and       Number and % of districts
Evaluation           submitting timely reports according
                     to National Guidelines on Drug        44(33%)   23(17%)   52%
                     Management
 No. of New Smear Positive TB patients reported to the                                                  99%
National Health Authority (cumulative per calender year)

   No. of New Smear Positive TB patients reported to the                                          87%
        National Health Authority (non-cumulative)
   No. of New Smear Positive TB patients reported to the
     National Health Authority through Private sector                                        79%
              (cumulative per calender year)

No. of New Smear Positive TB cases Suceessfully Treated,                                                102%
            (cumulative per calender year)

No. of New Smear Positive TB cases Suceessfully Treated,                                            95%
                  (non-cumulative)
No. of New Smear Positive TB cases Suceessfully Treated
among those managed in the Private Sector (cumulative                                       75%
                  per calender year)

  No. and % of districts reporting no stock out of first line                                           100%
         anti-TB drugs on the last day of quarter

  No. of warehouses refurbished at national/ provincial/             2%
  regional/ district level for the appropriate drug storage

No. and % of districts submitting timely reports according                            52%
      to National Guidelines on Drug Management

                                                                0%        20%   40%   60%   80%    100% 120%
                To-date
 First order for procurement of First Line
  Drugs have been matured with Global Drug
  Facility and 2nd order has been placed
 Warehouse at federal level has been
  refurbished and, medicines & other health
  products have been shifted there
 Accelerated Plan of Action has been
  submitted to GF and LFA for warehouse
  refurbishment
     Financial Summary GF R-8

  Budget      Utilization    Cumulative Cumulative
   P-4            P-4          Budget   Utilization
  (US $)        (US $)         (US $)     (US $)



0.18 million 0.075 million   2.2 million   1.66 million
   Round-9
Progress Update
          Consolidated Objectives
1. To pursue high-quality DOTS through countrywide quality
   assured bacteriology (PR-NTP)
2. To implement DOTS in secondary and tertiary care
   hospitals (PR-NTP)

4. To address TB/HIV (PR-NTP)
5. To enhance the capacity of health sector to detect and
   manage 80% of the estimated MDR-TB incident cases by
   year 2015 (PR-NTP)




7. To strengthen NTP for effective programme
   implementation (PR-NTP)
                  Consolidated Objectives & SDAs
                   SDA Consolidated SDAs
Round referenceObjectives
                 1      To pursue high-quality DOTS through countrywide quality assured bacteriology
R6                  1.1 Quality assured bacteriology at peripheral level laboratory network
R6                  1.2 Quality assured bacteriology at Intermediate level laboratory network
R9 and R6           1.3 Enhance diagnostic and infection control capacities of TB Culture & DST Laboratory network
                 2      To implement DOTS in secondary and tertiary care hospitals
                    2.1 Strengthen implementation of DOTS and management of adult difficult-to-diagnose and childhood
                        TB cases.
R-6 (MC)         3      To empower people with TB and communities
                 4      To address TB/HIV
R6                  4.1 Enhance TB/HIV collaboration
                 5      To enhance the capacity of health sector to detect and manage 80% of the estimated MDR-TB
R6 and R9               incident cases by year 2015
                    5.1 Enhanced capacity of hospitals and peripheral facilities to deliver and monitor inpatient and
R6 and R9               community-based treatment of MDR-TB cases.
                    5.2 Enhanced capacity of the hospitals to manage social support services for MDR-TB patients and
R6 and R9               their treatment supporters.
                    5.3 Enhanced program capacity to manage quality second line drugs and coordinate & monitor the
R6 and R9               implementation of MDR-TB case management.
                 6      To offer quality care to TB patients through a network of enabled private sector and parastatal
R-9 (MC)                hospitals, clinics and laboratories
                 7      To strengthen NTP for effective programme implementation
R6 and expansion    7.1 Strengthen NTP for effective project implementation
R6                  7.2 Capacity building
    Salient Features of Consolidated grant
• Grant Management Solutions (GMS) provided
  technical support through USAID
• Yr 3 & 4 of R-6 merged with Yr 1 & 2 of R-9
• Individual Periods and Targets of both grants are
  aligned
• Harmonize goals, objs, and SDAs over the
  various grants
• Impact, outcome and process indicators are
  synchronized and rationalized to keep within
  recommended limit
• Targets Aggregated in Consolidated PF
     Salient Features of Consolidated grant
• Baselines updated according to the latest
  available information
• M&E team retained
• Hospital DOTS expansion in 5 Tertiary Care
  Hospitals of Karachi
• Overlap / Duplication of SR efforts addressed
• Strengthening DOTS in 30 DHQ hospitals
  – Training of doctors, Paramedics and Lab persons
  – Management of Childhood TB & Difficult to diagnose
    cases
                     To-date
 R-9 Grant has been signed in conjunction with R-
  6 as consolidated grant
 First Disbursement of USD 8.8 million has been
  released by the GF
 The disbursement does not include funds for:
   All trainings till training plan on new matrix is
    approved by GF
   The funds for lab up-gradation will be released once
    GF has approve revised/accelerated plan submitted
    to it
   Funds for SRs till the final approval of SR capacity
    building plan is approved by GF
 SRs’ grant documents are being prepared
 Recruitment process has been initiated
 Hospital Induction Plan
for MDR-TB Management
Challenges & Constraints
                 Round-6

 Final financial settlement of Vehicles and Lab
  Equipment supplied by WHO is still pending
 Security Situation in different parts of the
  country
 Engagement of Health Managers in
  managing post flood situation leading to
  delayed reports
                Round-8

 Up-gradation / refurbishment of
  warehouses at different levels
 Meeting timelines and targets in post-
  flood scenario
         Management Letter

 Almost all issues raised in the management
  letter have been addressed
 The only pending issue is of US Dollar
  convertible account
                      Management Letter
Observation                             Action

Currency Exchange Rate                  Resolved in current PUDR
USD Convertible Account                 Request to be taken up by CCM
Separate Bank Accounts for all Rounds Resolved

Activities for reporting quarters       Resolved

Warehouse Refurbishment                 Accelerated Action Plan submitted to GF

Underperforming Indicators              Accelerated Action Plan has been prepared
(warehouses, timely submission of
PPM data)
Reporting Protocol for last Indicator   Protocol has been developed and circulated in
                                        current IPM
Reporting as per Drug Management        Protocol has been developed and circulated in
Guidelines                              current IPM
Data collection and verification from   PPM Unit is working on it
Thank you

				
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