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PPM (PPA) and ISTC in Mexico

PPM (PPA) and ISTC in Mexico. NTP. PPA O bjectives. Increase Respiratory simptomatics Improve quality diagnosis Strengthening case reference. Increase case notification Increase cure rate Avoid MDR and XDR Direct observe treatment

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PPM (PPA) and ISTC in Mexico

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  1. PPM (PPA) and ISTC in Mexico

  2. NTP PPA Objectives • Increase Respiratory simptomatics • Improve quality diagnosis • Strengthening case reference • Increase case notification • Increase cure rate • Avoid MDR and XDR • Direct observe treatment • Decrease direct and undirect cost for patients and institutions • Decrease: • TB Incidence, prevalence and • mortality • Reinforce DOTS strategythroughinterinstitutionalcoordinationfor TB prevention and care • Guarantedqualityattentiontoall TB patientsbasedon ISTC and officialNorm • Involvementtopublic and privatehealthinstitutionstomeet MDG accordingtothe TB Global Plan and STOP-TB strategy

  3. PPA Background, Mexico Governments by themselves can not solve TB problem Mexico has TB Official Norm from 1993, updated each 5 years and shows guidelines to be respected legally Mexico was considered a pilot country to implement the ISTC and implement them.

  4. PPA Background, Mexico August – November, 2006: National meetings with health public and private institutions to introduce the PPA objectives and action lines Activities: Review of current status about the care services on TB Overseeing the degree of involvement with the NTP and the private sector, laboratories, medicine and nurse schools, pharmaceutical industry and NGOs Draft of validated National Standards for TB Care based on the ISTC and National TB Official Norm

  5. Current status identified Lack of operational research on the attention, treatment outcomes and cost of services for TB patients . Weak linkage between official and private services. Lack of an effective reporting system from private health services. Lack of agreements between private and public health services with government

  6. Different activities per health provider, Mexico

  7. Estimated costs by private TB services

  8. Opportunities in PPA, Mexico (1) There is political will from the government and interest from public-private institutions. Great possibility to improve activities from national level to the local level. There are best practices on vinculation in some States in Mexico. Opportunity to foster a formal training programme in order to validate private Phisicians

  9. Oportunidades en APP, México Opportunities in PPA, Mexico (2) • Strong linkage between public and private organizations to benefit the NTP. • Agreements with: • National schools of medicine and nursing associations • National pharmacies association (ANAFARMEX) • National private hospitals association • National University (UNAM) • 2 chains of national private laboratories (el Chopo, Olarte and Akle) • Validation of processes by InDRE

  10. Opportunities in PPA, Mexico (2) Include traditional medicine (indigenous)

  11. Achievements • 1st Mexican Standars for Tuberculosis Care, validated by Ministry of Health • Instrument of verification about the grade of involvement of public-private health providers • Distribution of chart of rights and responsabilities of the TB patients (Mexican version).

  12. Next steps To introduce the “Mexican standards for Tuberculosis care” to ALL Ministries of health in the country. Implementation in States with high TB burden (Guerrero, Chiapas, Baja California, Estado de México, Distrito Federal, Nuevo León, Jalisco y Chihuahua). Development of a National Standars pocket guide Engagement of societies of expert specialist. To start validation of technical capacity in public and private laboratories by InDRE

  13. PPA Action Plan

  14. Time line 2nd Visit 1st visit Workshop November the 14th, 2006 Monoitoring and evaluation by TB-CAP/ USAID Improve statal specialists in TB attention 2009-2010 Mexican Standars for Tuberculosis Care (MSTC) Patients chart Implementation and scaling up of PPA by MSTC Index to measure the degree of involvement of public-private health providers

  15. Gracias Dr. Martín Castellanos Joya Encargado del Programa Nacional para la Prevención y Control de la Tuberculosis t 2614-6436, f 2614-6433 martinjoya@yahoo.com.mx http://cenave.gob.mx/tuberculosis/ Unión InternacionalContra la Tuberculosisy EnfermedadesRespiratorias

  16. Recomendations (1) Formalize the Public-Private Aliance (APP) trough agreements in the STOP-TB Committee México, to assure sustainability of this iniciative to benefict NTP. To develop an easy tool to measure the colavorative garde in TB attention (diagnosis and treatment. To analyze,document and expand APP activities on order that improve TB control

  17. Recomendations (2) Build capacity in public and private services by allied specialist To develop a wallet guide of the Mexican standars for TB care. Expand APP plan to all country.

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