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ISTC The Indonesian Experience

ISTC The Indonesian Experience. Erlina Burhan Indonesian Society of Respirology ISTC Task Force Indonesian Medical Association. Contents. Background Initiating ISTC Endorsement Key events Roll out of ISTC Conclusions. Back ground - Present practices & need for ISTC.

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ISTC The Indonesian Experience

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  1. ISTCThe Indonesian Experience Erlina Burhan Indonesian Society of Respirology ISTC Task Force Indonesian Medical Association

  2. Contents • Background • Initiating ISTC • Endorsement • Key events • Roll out of ISTC • Conclusions

  3. Back ground - Present practices & need for ISTC • TB care is standardized & implemented in the public sector mainly through the network of Primary Health Center’s and some hospitals • CXR is the commonly used diagnostic tool in hospitals & private practice • Sputum smear is very much underutilized in hospitals & private practice & sputum culture is uncommon • Many doctors are using other tests (serology test, PCR) instead of sputum testing • Treatment regimens vary considerably in private practice • Hence the need for a tool to bridge the NTP with Professional societies, Private sector & Hospitals • The Tool - ISTC

  4. Process of introducing ISTC • March 2005 : Sensitization of key opinion leader during JEMM • July 2005: Introduction of ISTC draft to key opinion leaders (WHO/ KNCV) • August 2005: Introduce ISTC to professional organization • September 2005: Workshop for professional organization to develop a plan to endorse, socialize, disseminate and implement ISTC • September 2005: appoint ISTC team led by Indonesian Society of Respirology • October 2005: Various professional organization Meetings • November 2005: First National TB Congress with presentations on ISTC • December 2005: Finalizing Work Plan for socialization • Supported closely by the ATS with several visits from Dr Phil Hopewell and Ms Fran Du Melle

  5. Process of Endorsement • January 2006: • First formal Endorsement Letter fromIndonesian Society of Respirology • Introducing ISTC to the President of the Indonesian Medical Association and other Specialist Organizations (organized by Indonesian Society of Respirology) • February 2006: • Follow up meeting and Discussion with Indonesian Medical Association • Indonesian Medical Association endorse the standards in February 2006

  6. Launch of ISTC • World TB Day 2006 : IDI (Indonesian Medical Association) formally endorsed the standards & launched by Minister of Health

  7. Endorsement and Key Events • ISTC Task force at IMA was established • ISTC short version in Bahasa (incl addendum) Indonesia was published and disseminated • ISTC is included in various scientific meetings of professional organization

  8. Roll Out ISTC With support from NTP, WHO, and KNCV; • Indonesian Society of Respirology has implemented: • Two days Workshops in 13 provinces in coordination with local chapters of professional societies & Provincial/District health authorities • ISTC Short version were delivered to all participants • All the topics were delivered as a CD and handout to participants • Indonesian Medical Association • Develop National Task Force • Socialization and establishment of Provincial TF in 12 provinces to ensure sustainability & local ownership • Development guideline for implementation TB in Private Practitioner • Piloting TB in PP through certification and accreditation scheme

  9. TOPICS Why & What of ISTC Epidemiology of TB Standard diagnosis Standard treatment Standard Public Health Responsibility MDR TB TB-HIV The Role of Chest X Ray Group work & discussions

  10. The Role of Professional Organizations Socialization and dissemination Having ISTC as a topic in their annual meetings, scientific sessions and seminars Meetings to socialize and dissemination the standards ( Hands on ) ISTC articles in Journals

  11. Conclusions Professional society members relate more easily to ISTC than NTP guidelines since it is evidence based & more clinical oriented ISTC can act as the bridge between the NTP, Professional societies & Private sector NTP’s can outsource the socialization & roll out of ISTC to Professional organizations • Involvement of key professional opinion leaders/champions, right from introduction is important for buy in, acceptance & endorsement • A Hospital assessment study done on DOTS practices in 2007/8 in Public & Private hospitals acts as baseline data to evaluate the impact of ISTC in future.

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