RNTCP Performance Review

1
RNTCP Performance Review

• Ahmedabad Region
• Dr PV Dave,State TB Officer,
• Gujarat

2
Involvement level of General Health Staff in
RNTCP patient care Gujarat August 07

• BACKGROUND
• Stepping up the accountability of the general
  health system in RNTCP
• Aim - To assess the involvement of general
  health staff in RNTCP
• Analysis of home visits of TB patients conducted
  by various cadre of staff from the general health
  system in Gujarat during past one year (July 06
  June 07)
• METHODOLOGY
• Multistage sampling
• Stage 1 Simple Random Sampling (lottery
  system) for selection of PHCs
• Stage 2 Systematic random sampling of patients
  from the selected PHIs
• Sample size
• PHCs selected would be 129 (one per TB Unit)
  representing Gujarat
• 387 patients to be interviewed at their
  residence (3 per PHI selected)
• A simple format in excel sheet used for data
  collection through home visits and records of
  patients referred to verify the information

3
Initial Home Visit conducted by
4
Visit of MO PHI to patients residence during the
course of treatment
5
To Strengthen Case Holding for better treatment
outcomes in all TB cases

• The following needs to be strictly done in the
  ground
• Initial home visit should be done by health
  worker of the PHI using the IHV format.
• MO PHI must visit the home of the all patient to
  verify adequate arrangement of DOTS, acceptance /
  motivation of patient and resolve issues if any
• Default retrieval action and management of
  adverse drug reactions to be promptly done for
  every case wherever necessary
• Treatment cards should be regularly updated and
  reflect the ground situation on progress of the
  patient.
• Progress of each and every patient should be
  monitored by MO PHI and BHO during their sector
  review meetings on case to case basis
• These basic processes should be ensured by BHOs
  and CDHO in all PHIs

6
(No Transcript)
7
Cure Rate Vs Case Detection Rate (2Q06/2Q07)
Gujarat State
8
Cure Rate Vs Case Detection Rate (2Q06/2Q07)
Ahmedabad Region
9
TB Suspects Examined per 1,00,000 per quarter 2nd
Quarter 2007
India 144 Gujarat 142
10
TB Suspects Examined per lac population per
quarter TB Units of Ahmedabad Region 2nd
Quarter 2007
11
TB Suspects Examined per lac per quarter TB
Units of AMC 2nd Quarter 2007
12
of PHIs referring 2-3 of new adult OPD
2Q07TB Units of Ahmedabad Region
13
TB Suspects Referral Rate - Civil Hospitals
(last 4 quarters)Ahmedabad Region
Norms 2-3 of new adult OPD for sputum microscopy
14
Sputum Positivity Rate
Gujarat State 2nd Quarter 2007
15
Sputum Positivity Rate 2Q07TB Units of
Ahmedabad Region
16
NSP Case Detection Rate TB Units of Ahmedabad
Region 2nd Quarter 2007
17
NSP Case Detection Rate TB Units AMC 2nd
Quarter 2007
18
Sputum Positive of Total New Pulmonary
CasesGujarat State2nd Quarter 2007
19
Sputum Positive of Total New Pulmonary Cases
2Q07 TB Units of Ahmedabad Region
20
Repeat Sputum Examination v/s Smear Neg Cases
Registered (NSN CAT II Others) - 2Q07TB Units
of Ahmedabad Region (1)
21
Repeat Sputum Examination v/s Smear Neg Cases
Registered (NSN CAT II Others) - 2Q07TB Units
of Ahmedabad Region (2)
22
NSP Conversion Rate TB Units of Ahmedabad
Region 1st Quarter 2007
23
NSP Conversion Rate TB Units AMC 1st Quarter
2007
24
NSP Cure Rate TB Units of Ahmedabad Region 2nd
Quarter 2006
25
NSP Cure Rate TB Units AMC 2nd Quarter 2006
26
NSN Treatment Completion Rate TB Units of
Ahmedabad Region 2nd Quarter 2006
27
NSN Treatment Completion Rate TB Units of
AMC 2nd Quarter 2006
28
Conversion rate in Sm ve Re-treatment cases
1Q07 TB Units of Ahmedabad Region
29
Cure Rate in Sputum Positive Re-treatment Cases
Gujarat State 2nd Quarter 2007
30
Cure rate in Sm ve Re-treatment cases 2Q06 TB
Units of Ahmedabad Region
31
Default Rates in all type of TB cases 2Q07 TB
Units of Ahmedabad Region (1)
32
Default Rates in all type of TB cases 2Q07 TB
Units of Ahmedabad Region (2)
33
Death Rates in all type of TB cases 2Q07 TB
Units of Ahmedabad Region (1)
34
Death Rates in all type of TB cases 2Q07 TB
Units of Ahmedabad Region (2)
35
Quality of DOTS Indicators
36
of NSP cases started RNTCP DOTS within 7 days
of diagnosis - 2Q07 TB Units of Ahmedabad Region
37
of NSP cases registered within one month of
starting RNTCP DOTS treatment - 2Q07 TB Units of
Ahmedabad Region
38
of Cured NSP cases having end of treatment
follow up sputum done within 7 days of last dose
2Q06TB Units of Ahmedabad Region
39
of PHI that submitted monthly PMRs for all 3
month in 2Q07TB Units of Ahmedabad Region
40
Involvement of NGOs and PPs - 2Q07Districts of
Ahmedabad Region
41
MOTCs participation in the DTC level RNTCP Review
Meetings on 7th each month(Jan 07 June
07)TB Units of Ahmedabad Region (1)
42
MOTCs participation in the DTC level RNTCP Review
Meetings on 7th each month(Jan 07 June
07)TB Units of Ahmedabad Region (2)
43
Average number of tours by MOTCs in a month 2nd
Quarter 2007TB Units of Ahmedabad Region
44
Results of Test for Gujarat DTOs - PS (HFW) -
18th May 2007Ahmedabad Region
45
Results of Test for MOTCs Commissioner (H) -
7th August 2007TB Units of Ahmedabad Region (1)
46
Results of Test for MOTCs Commissioner (H) -
7th August 2007TB Units of Ahmedabad Region (2)
47
Results of Test for BHOs other than MOTCs STO
- 7th September 2007TB Units of Ahmedabad
Region
48
Role of CDHO / DTO / MOTC / BHO in Sputum
Collection and Transport System (1)

• Arrange training of the all the BHOs, STS, STLS,
  DMC MOs and LTs, PHI MOs and the staff nominated
  for sputum collection and transportation from the
  PHI
• To finalize and submit the list of the one
  nominated person from all Sputum Collection
  Centers (PHIs other than DMCs) in consultation
  with MO PHI for sputum collection and
  transportation. If required, another person can
  be nominated for transportation. MOTCs to assist
  the DTO to finalize the list
• To collect and provide all consumables, formats,
  records and sputum transport boxes from STDC
• Ensure that there is no shortage of material in
  any center in the TU. Necessary provision of the
  material should be promptly done at centers with
  shortage materials identified during supervisory
  visit

49
Role of CDHO / DTO / MOTC / BHO in Sputum
Collection and Transport System (2)

• Review the progress of the sputum collection and
  transportation from all centers on a weekly basis
  with the MO DMCs, LTs and STLS
• To use supervisory checklist during visits to the
  centers included in the study and to provide
  support to overcome operational difficulties
  during the study period
• Facilitate the correct and regular updating of
  the records in the study
• DTOs should ensure that all level of personnel
  know and exercise their responsibilities as per
  their work instructions

50
Summary Register of Sputum Collected at DMC LT
Name of the DMC__________________________________
__ Name of the Month ___________Dates of the
week _________(Mon) to ________(Sun)
Monitoring the referrals of TB suspects and
quality of sputum sample transported from each
PHI by the BHO is crucial to ensure early case
finding and prompt management of TB cases.
51
ACSM (IEC Activities)Districts of Ahmedabad
Region
52
Thank You