Post on 05-Dec-2014
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Tuberculosis and PSI
Jennie Quick, PSI
April 29, 2010
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Overview
• Who is PSI?
• PSI’s approach to public health
• What is social franchising?
• PSI and TB
• Next steps
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Who is PSI?
• International non-profit• Incorporated in 1970• More than 60 country
offices• Based in Washington• World leader in social
marketing and behavior change communication
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Key Health Areas
• HIV/STI prevention• HIV Counseling and Testing (CT)• Reproductive Health• Malaria• Diarrheal Disease• Pneumonia• Tuberculosis
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PSI and TB
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What is social franchising?
Franchise Responsibility:
• Training
• Quality Assurance
• Monitoring and Evaluation
• Drugs, Supplies and Consumables (as appropriate)
• Communication, Branding and Demand Creation
Franchisee Responsibility:
• Quality Service Provision (according to standards and protocols)
• Implement Recommendations
• Recording and Reporting
• Participate in Network Activities
Once established, a successful social franchise can be rapidly scaled-up with limited cost and expanded to include other health
services.
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Sun Quality Health - Myanmar
• Launched in 2004• Passive case-finding model • Franchise of General Practitioners
in the private sector• Providers trained in TB symptomatic screening, diagnosis and treatment • Refer suspected TB cases to qualified labs • Treatment supporters provide follow-up to encourage adherence, trace
clients who default on treatment and conduct contact tracing • PSI officers monitor quality assurance regularly • Demand creation through IPC and mass media
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Results from Myanmar
• 150 townships in 11 states • 691 providers, 145 labs• 116,849 clients tested for TB• 53,890 registered TB cases• 27,711 Category 1 cases• 84% treatment success rate• 10% contribution to national case
detection rate• >55% of patients are from the
lowest two socio-economic groups
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GreenStar - Pakistan
• Launched in 2005• Active case-finding by Community Health Officers• Door-to-door screening in high burden neighborhoods • Community-events for sputum collection• Private general practitioners trained in symptomatic screening,
diagnosis and treatment • Referrals provided to qualified labs • Treatment supporters to encourage adherence, trace patients
who default and to conduct contact tracing• QA visits from GreenStar project officers
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Pakistan: GreenStar and TB
• 1,080 providers, 49 labs• 36,277 community-based
treatment supporters trained • 2,100,000 people reached• 40,419 registered TB cases• 89% treatment success rate• 33-51% contribution to case
detection rate in areas where it operates
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TB Communications
• Where?– Central Asia, India,
Kenya, Laos, Myanmar and Romania
• What?– TB (awareness,
treatment seeking, adherence, etc.)
– TB/HIV– Stigma
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PSI and TB/HIV
• Non-medical TB screening of HCT clients and referrals to laboratory diagnosis– India, Mozambique,
Myanmar, South Africa, Zambia, Zimbabwe
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South Africa: HIV/TB Integration
• Launched in 2006• Mobile HIV counseling and testing
(CT) for individuals from out-patient departments/TB wards
• HIV-positive individuals referred back to clinic
• July 2006 - Sept 2009, >7,000 patients tested for HIV
• Among TB patients, 90% tested HIV-positive
• 80% of referrals tracked successfully
• Telephone tracking ensures patients use referrals
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Zimbabwe: HIV/TB Integration
• HCT Clinics perform symptomatic screening
• Recently, clinics began offering sputum microscopy onsite
• Individuals who are diagnosed with TB are referred to public health facilities for treatment
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Next Steps
• Continued TB service delivery through existing franchises– Scale-up of existing programs – Launch of new networks
• Support NTCPs and other partners in delivering evidence-based communications for TB and TB/HIV
• Expand TB services offered within HCT clinics – including lab diagnostic services
• Strengthen TB screening among PLWH by scaling up screening through HCT
• Increase support to NTCPs to provide provider-initiated HIV counseling and testing to all TB suspects and patients
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Thank you!
For more information on PSI and TB
please contact:
Megan Elliott
melliott@psi.org