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Nationwide scale-up of TB/HIV collaborative activities in Ethiopia. Yibeltal Assefa, MD, MSc Head, Health programs Department TB/HIV core group Addis Ababa November 11-12, 2008. Outline of presentation. Background Successes Coordination Service delivery M and E Challenges
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Nationwide scale-up of TB/HIV collaborative activities in Ethiopia Yibeltal Assefa, MD, MSc Head, Health programs Department TB/HIV core group Addis Ababa November 11-12, 2008.
Outline of presentation • Background • Successes • Coordination • Service delivery • M and E • Challenges • The way forward
Ethiopia • East Africa • Area –1.2 million km square • Population 80 Million • 84% live in rural area • Administratively, divided into 9 Regions and Two administrative Cities
Tuberculosis One of the 22 HBC, 7th in the row Incidence-379/100,000 Smear positives-168/100,000 CDR-32% TSR-85% HIV Generalized epidemics Adult prevalene-2.2% Around 1 million PLHAs 290,000 PLHAs need ART 165, 000 PLHAs are started on ART (58% coverage) Background
Successes • Coordination • THAC established in 2004 with alternative chairmanship between TB and HIV programs • THAC revitalized and TWG established in April 2007 • TB/HIV Implementation guideline revised in 2008 • Co management adaptation done in 2008 • Training manuals are harmonized • TB/HIV training manual for physicians • TB/HIV training manual for HOs and nurses
Successes---coordination • Harmonized TB/HIV plans for all partners-one plan • Regional Working groups are being established since February 2008-all regions have TB/HIV working group
Successes • Service delivery • TB/HIV service delivery was piloted in 9 sites in 2004 • Currently we have 523 sites • Planned to reach 680 sites in 2008/09
Decreasing Burden of TB in PLwHIV (The 3Is) • Intensified TB case finding, being done in chronic care set ups-it is a standard care • IPT is being offered for eligible clients, and has been one of the focus area • TB infection control has been incorporated in the newly developed training material; one of the emphasis area for this year.
Decreasing the burden of HIV in TB pts • HCT for TB patients • Provision of CPT for PLwHA • Provision of ART
Successes • Monitoring and evaluation • One standard, harmonized, integrated and comprehensive register and reporting format developed • All partners agreed to use one them.
Challenges • M and E Assessmentsof facilitiesindicated that • more than 70% of TB patients are tested for HIV in the majority of TB/HIV sites • in some facilities more than 90% are tested • 85% of HIV positive patients are screened for TB in 16 health facilities assessed • BUT NOT CAPATURED IN ROUTINE DATA COLLECTION OF THE GOVERNMENT • INH shortage-temporarily
The way forward • Further scale up TB/HIV collaborative activities • Work with partners for three ones • One coordinating authority (MOH) • One plan • One M and E system • Ensure continuous supply-The HIV program will procure INH.