Public Private Mix
Experience for TB control
National TB Control ProgramMinistry of Health
Government of Pakistan
TB Situation in Pakistan
Facts and Figures
• Ranks 8th among HBCs, 300,000 new TB cases/ year
• 15000 new MDR cases/year
Mile stones in PPM
• Inititiation of PPM - 2004
• No. of GPs engaged through PPM – 1600
• No. of NGO outlets providing TB services - 110
• No. of NGOs involved in ACSM - 7
PPM Progress in Pakistan
• Clear strategic vision
• First Public Sector allocation for PPM in Health
• Secured resources for PPM
o PC-1 – 8 Million
o GF-Round 2 – 1.5 Million
o GF-Round 3 – 4 Million
o Round 9 – 20 Million
o TBCAP - 0.3 Million
• Systematic approach
– Situation Analysis and operational plans
� Partners identification and mapping
� Good Life model 5 mega cities (1000 GPs)
� NGOs model
�AKHSP 5 Districts
�PATA 84 Districts
�TB CAP (5 NGOs) 5 Cities (400 GPs)
� District model 13 Districts (200 GPs)
� ACSM 57 Districts
� MDR 3 Pilot sites
� Evaluation
PPM Progress in Pakistan (cont…)
Active case detection
through chest clinic
Active case detection
through chest clinic
Paid by NGO.Paid by NGO.
Private Sector Contribution
Private Sector contribution in TB Control
Implemented in
how many total
districts*
Total cases
registered in
2008
Treatment
success in 2008
Total cases
registered in
2009
Contribution (%)
in National Data
in 2008
Districts led
model13 1458 94% 2862 0.6
Franchise model 5 12065 88% 6254 4.9
NGO led model
(PATA, AKHSP,
MALC, USAID)
101 10096 90% 19582 4.1
Gulab Devi 1 9545 71% 14464 3.8
Total
Contribution in
National Data
120 33164 84% 43162 13.3
* Districts may be overlapped, as more than one model is implemented in a district
PPM Scale up Plan
• Evaluation of ongoing PPM models
• Sustain and expand coverage in private sector
through public sector and Global Fund rounds
• PPM for DR-TB, TB/HIV and ACSM
• Develop National M & E Plan to collect
disaggregated data from Private sector
Technical Assistance Required
• Technical Support for the Development of
M & E system for PPM
• Third Party evaluation of various PPM models
• Technical Support in new areas of PPM; for
example PPM for DR-TB and PPM for TB/ HIV
Branding of Promotional Boards
Branding of Promotional Boards
Thank You