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Partnership at country level; the Nigerian Experience

Partnership at country level; the Nigerian Experience. By Dr T.O. Sofola National coordinator NTBLCP

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Partnership at country level; the Nigerian Experience

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  1. Partnership at country level;the Nigerian Experience By Dr T.O. Sofola National coordinator NTBLCP Nigeria

  2. OUTLINE OFPRESENTATION • Background Information • Status of Partnership • DOTS Expansion • Data • Challenges • Financial Situation • Conclusion

  3. Nigeria:Background information • Population: 126 m. • 36 states + FCT • 774 LGAs • Life expectancy : 48 (02) • Economy , mainly on Export of Crude Oil. • 70% below poverty line (2002) • GNP per capita. $280 (1998) • Public Expend. On Health as % of GDP: 0.3% (’98)

  4. Background • Nigeria 5th among 22 high burden countries in the world • WHO estimates for 2002 were • 102 per 100,000 pop for smear positive cases • 235 per 100,000 for all forms of TB • TB burden is further compounded by the worsening HIV/AIDS epidemic. • TB Control based on DOTS • Nigeria is committed to global targets.

  5. Partners as at 2001 • Damien Foundation of Belgium • Department for International Development • German Leprosy Relief Association • German Bank for Reconstruction • Netherlands Leprosy Relief • World Health Organization

  6. Map of Nigeria showing DOTS States Sokoto Katsina Jigawa Yobe Zamfara Borno Kano Kebbi Bauchi Gombe Kaduna Gombe Niger Adamawa Plateau Plateau FCT Nasarawa Kwara Oyo Taraba Kogi Ekiti Osun Benue Ondo Ogun Enugu Lagos Edo Ebony Anambra Non DOTS States Cross River Abia Imo Delta Old DOTS states Akwa Ibom Bayeisa Rivers

  7. Expanded Partnership (National Inter-Agency Coordinating Committee)

  8. NICC: TERMS OF REFERENCE • Assist/provide strategic & technical guidance • Explore means of strengthening & expanding participation in TB control • Advocate for & mobilize resources to support TB control

  9. Organogram of the NTBLCP

  10. THE NTBLCP SUPPORT PROJECT Development Partners Agencies Provides drugs, Equipment, Logistics, Sponsor Training, Technical Support Other Support • Federal Government provides Policies, Strategic Planning, Coordination, Storage and distribution of drugs, • Technical support Supervision training • Other Support State Government Provides Staff Infrastructure, Running cost, Drugs Other Support Local Government Provides Staff Infrastructure Other Support State TBL: Control Programme TB Services in LGAs Diagnose. Treat and Cure TB. Patients Reduction on TBL Transmission

  11. Monitoring & Evaluation Plan • Improving utilization of data from routine reporting & recording • Monitoring & supervision by National Experts • Joint International Mission (External/Internal Consultants) • Periodic review and evaluation

  12. Achievements • Improved political commitment • 5-year Strategic plan in place • Capacity to supervise & monitor is strengthened • DOTS expansion drive on-going • New initiatives & approaches embarked upon (TB/HIV, PPM, Operational research & Community DOTS)

  13. Map of Nigeria showing DOTS States Sokoto Katsina Jigawa Yobe Zamfara Borno Kano Kebbi Bauchi Gombe Kaduna Gombe Niger Adamawa Plateau Plateau FCT Nasarawa Kwara Oyo Taraba Kogi Ekiti Osun Benue Ondo Ogun Enugu Lagos Edo Ebony Anambra New DOTS States Cross River Abia Imo Delta Old DOTS States Akwa Ibom Bayeisa Rivers

  14. Progress in DOTS expansion

  15. Status in DOTS States • Constant supply of drugs and lab. Reagents • Reliable laboratory services • Free anti-TB drugs and lab services to patients • Data collection system in place • Supervision and monitoring system in place • Trained health staff • Treatment of patients according to WHO guidelines (Directly Observing Treatment)

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  17. GRAPH SHOWING COMPARISON IN TB CASE NOTIFICATION IN NIGERIA BETWEEN Q1.2002 AND Q1.2003

  18. Trend of HIV prevalence among PTB, STD and ANC attendees 1991-2000

  19. Key Challenges • Sustain national & external funding • Sustain anti-TB drugs & lab reagents • Expand TB diagnostic services network and quality assurance • Setting up/running the reference labs • Sustain DOTS expansion drive • Continue human resource development • Managing & coordinating new partnerships

  20. Key activities for implementation in 2004 • Enhance lab performance (equipment, materials & quality assurance) • Train existing and pre-service staff • Ensure TB allocation/release in Federal, state & LGAs budgets • Intensify improved drug management system • Implement consistent supervision & monitoring • Expand reporting network • Get all service providers on board • Implement COMBI

  21. Projected financial situation for 2004

  22. CONCLUSION • Nigeria is the 5th highest TB burden nation • Inadequate funding hampered the rapid implementation of DOTS nationwide • Now at point of rapidly expanding DOTS throughout the country (Improve case finding & cured rate) • Therefore the need to continue & forge partnerships is paramount • We hope to achieve the global targets set for 2005

  23. Thank you Thank You

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