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District/sub-district analysisAll StatesSpecific actions included in Annual Action plan Universal Access for TB CareMajor discussion point in STO's Biannual Review meeting conducted from 29th to 31st January 2010.CTD developed a Guide to programme managers on Universal access for TB care. LinkPriority activities identified by states to increase case detection were reviewed in the STO/Consultants review meeting on 17th and 18th June 10.
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1. Revised National TB Control Programme
3. Human Resources:
Still continues as an important issue in most of the states.
STO
STC
DTO
Additional contractual posts
(Asst programme officer/ Epidemiologist (1per state), DOTS-Plus site MO(1/site), DOTS-Plus site SA(1/site), Sr. LT at IRL (1 per IRL), Store Assistant (SDS) (1 per SDS) , DEO (IRL) (1 per IRL), Sr. DOTS Plus and TB HIV Supervisor (1 per district)
4 states- Gujarat, West Bengal, Delhi and Haryana has appointed.
Tamil Nadu, Orissa, Bihar, Uttar Pradesh and J&K has not initiated any actions
Other states are at various stages of procurement
Action taken Report on the minutes of State Health Secretaries Meeting 15th/16th January 2010- cont..
4. Training Status under RNTCP.
Review of the training status done during the STO/Consultants meeting in January 2010
Detailed plan was prepared by states to strengthen the training activities.
Incorporated in the annual action plan.
30% of the trainings planned for the year 2010-11 have been completed by June 2010.
STOs were advised to follow the training plan.
5. Strengthening the supervisory activities at all levels
States have reported improved supervisory visits, reviews and Internal evaluations. Link
Strengthening involvement of General Health system:
GOs to ensure that CMOs review RNTCP,
Govt MO don’t prescribe TB drugs outside the programme
9 states already issues GOs (Kerala, Karnataka, UP, MP, Rajasthan, Gujarat, Andhra Pradesh, Mizoram and Uttarakhand)
Other states-under process.
Action taken Report on the minutes of State Health Secretaries Meeting 15th/16th January 2010- cont..
6. Universal Access to TB Care
8. Steps to Universal access Most of the un-notified cases are seeking health care but not being captured by the system.
They can be reached by
Increasing suspects examination rate
National level- 160/lakh/qtr
District level- wide variations
Ensure adequate infrastructure
DMCs-trained LTs
TUs
Sputum collection and Transport facilities
Medical Colleges
Involving all departments in Medical Colleges
Strengthening Supervision and Monitoring
Filling up of vacant posts
Proactive programme review at all levels
Implementing Tribal Action Plan
9. Other Health Care providers
Other Govt health sectors, corporate sector, ESI, Mines etc
NGO/PP involvement
IMA, CBCI
GF Rd-9 Project-
ACSM-374 district
IUATLD- (300 districts)
World Vision-(74 districts) Steps to Universal access
10. Contact Tracing
Contact tracing of sputum positive patients
Intensified case finding activities in High risk population
HIV
Smokers
Diabetes
Linking with Anti-natal care services
Mothers
Child
13. Finance Financial Status
Commodity Assistance
14. Thank You
15. States with no full time STO
16. States with no full time STO cont..
17. State wise vacancies at State TB Cell
19. Positions of District TB Officers
20. Positions of District TB Officers
21. Key Staff Positions – Vacant, Untrained – 1Q10
22. State Level RNTCP Reviews in 2009/1st qtr 2010
24. Internal Evaluation by States in 2009 – 1q10
25. Internal Evaluation by States in 2009 – 1q10
26. Issues in TB HIV Co-ordination TB HIV Coordinators not appointed in many states eg. Bihar, HP, Jharkhand, Chattisgarh, Kerala
District co-ordination committees not formed in many districts of Bihar and MP
Joint supervisory visits by STC & SACS to districts not happening in many states.
Expediting district level trainings in Intensified TB/HIV Package in the preparatory states (Rajasthan, Kerala, Assam, WB, Orissa, Punjab and Chandigarh)
Expediting state level trainings in Intensified TB/HIV Package, procurement of CPT pouches and printing of modules and registers/referral forms in the newly launched states (UP, MP, Haryana, HP, Uttarakhand, Chattisgarh, Jharkhand, Sikkim, Tripura, Arunachal Pradesh and Meghalaya)
Key challenge is to bridge the gap at service delivery level between RNTCP and NACP –
By co-locating existing ICTCs and DMCs (AP & Karnataka: In about 33% of the DMCs, ICTC is not co-located. Maharashtra: 65% of the DMCs, ICTC is not co-located)
By establishing Facility integrated ICTCs and roll-out of Whole blood testing for HIV.
The linkage of the HIV positive TB patients to ART centres is weak in many states and needs to be strengthened.
29. Jharkhand
30. Jharkhand
32. Gujarat
33. Gujarat
35. Bihar
36. Bihar
37. BIHAR Rate contract for laboratory consumables not finalized since June 2008. Regular shortage of consumables in all districts
All state level contractual posts vacant
No Deputy STO or MO-STC . STO has multiple charge
No printing done in the state for the last 2 ½ years. Shortage of all recording and reporting formats. Districts resorting to photocopying
Delay in Contract renewal , payment of remuneration and reimbursement of POL to contractual staff varying from few months to a year.
Although 200 laboratory technicians appointed in February 2010 by state health society, only 14 were trained for RNTCP lab work at state level.
DOTS PLUS committee not yet formed
39. Andhra Pradesh
40. Andhra Pradesh
42. Arunchal Pradesh
43. Arunachal Pradesh
45. Assam
46. Assam
48. Chhattisgarh
49. Chattisgarh
51. Delhi
52. Delhi
54. Goa
55. Goa
57. Haryana
58. Haryana
60. Himachal Pradesh
61. Himachal Pradesh
63. Jammu & Kashmir
64. J&K
66. Karnataka
67. Karnataka
69. Kerala
70. Kerala
72. Madhya Pradesh
73. Madhya Pradesh
75. Maharashtra
76. Maharashtra
78. Manipur
79. Manipur
81. Meghalaya
82. Meghalaya
84. Mizoram
85. Mizoram
87. Nagaland
88. Nagaland
90. Orissa
91. Orissa
93. Punjab
94. Punjab
96. Rajasthan
97. Rajasthan
99. Sikkim
100. Sikkim
102. Tamil Nadu
103. Tamil Nadu
105. Tripura
106. Tripura
108. Uttar Pradesh
109. Uttar Pradesh
111. Uttarakhand
112. Uttarakhand
114. West Bengal
115. West Bengal