Action%20Plan

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• Action Plan
• Prepared by
• Ismat Ara Khusheed
• Deputy Director,PTP Sindh
• At JAPAN 2006

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SINDH
100 DOTS Coverage since November 2003
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GENERAL FEATURES

• Name city district Government ,Karachi
• Area 3527sq.km
• Population Density2795 per sq km
• Average housr hold size 7
• Literacy rate 60
• Nos of town 18
• Nos of diagnostic centre 55
• Nos of treatment centres 111
• Average public transport fare Rs.10 one way
• Average time travel 45 minutes one way by public
  transport.
• Large no of migrants who have flocked to karachi
  in search of opportunities.

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Back Ground

• Karachi is the largest city of Pakistan and the
  capital of its southern province of Pakistan
  karachi is divided in to 18 towns every town is
  supervised by town health officer.
• Mega city is administered by city district
  Govt. Of karachi (CDGK).which has an elected
  city council each town has its own council and
  Nazim.
• Mega city like karachi pose a great challenge to
  community based urban DOT strategy the public
  sector cannot achieve the target of detecting all
  new TB cases hence PTP is in need of building
  partnership to bridge the gaps between public and
  private sectors prevailing in the urban DOTS.

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Organogram
Technical Support from NTP
Secretary Health
DG Health
4 NPOs and 1 Sociologist
Director TB Control Program
Deputy Director Hyderabad
Deputy Director Larkana
Deputy Director Karachi
Deputy Director Sukkur
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DEFAULT RATE



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OUT COME

• Dots coverage 2003 100
• New case detection sspos 52
• Case detection of all type 63
• Smear conversion 82
• Success rate 86
• Default rate 14

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Stakeholders Analysis
Beneficiaries Implementing Agencies. Decision makers. Funding agencies Potential Opponents.
Patient EDO THO BHU. RHC Teaching Hospital Ministry of Health National tuberculosis Moh Ptp GFATM General practioner
Community people Partner agencies FIEDELIS CIDA WHO National Tuberculosis program CIDA WHO FIEDELIS Private Hospital quak
EDO. NGO TB Association Gfatm Provisional Tubrtculosis program Quack hakeems
Traditional healers
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Problem Analysis
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Poor capacity of health workers
Problem Analysis
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Objective Analysis
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Project Selection
Sufficient HE to PT. Good Linkage system approach Economic development approach H.E AND economic development approach.
Costs Benefit 5 4 3 4
Sustainability 3 3 3 5
Feasibility 4 4 2 5
Available resources. 4 3 3 3
16 14 11 17
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Project selection

• Provisional tuberculosis programme should
  emphasize on effective case holding mechanism
  through health education and capacity building of
  health workers.

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PDM

• Project Name effective case holding mechanism
  through healtteducation and referral syatem.
• Target area slums of six towns of Karachi
  city.
• Target group The target population in slums and
  katchi abadies of six towns ,of karachi is
  approximately 3 million
• Duration 1-7-2006 TO 31-6-2009
• Date 23-2-2006.

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Narrative Summary O. V. Indicators Means of Variation Important Assumptions
Overall Goal To reduce the mortality and morbidity due to tuberculosis in Karachi. The mortality and morbidity is reduced by 10 by 2009 in 6 towns in Karachi. Health management and information system. Sindh health department continues to include PTP as one of the priority programmes.
Project purpose To reduce the default rate in Karachi. The default rate has reduced by half by the year 2009. Quarterly reports, Annual reports. The population in the slum areas in 6 towns in Karachi do not increase drastically.
OUTPUTS. 1. Sufficient H.E is provided to TB patients and community. 1- TB patient s knowledge on TB is increased by 30 by the year 2007. -Project survey. -Project records on trainings conducted. -Monthly reports, Minutes of meeting. TB register. The TB situation of migrant population do not become worsen.
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2. Capacity of health workers is improved through training. 3- Good linkage between diagnostic treatment centers established for effective case holding activities. 2-. 50 of LHW have completed TB training by 2007. 3- Number of diagnostic centers that have monthly meeting with treatment centers increase by 80 in 2008. 4- Number of properly transfer out cases increase by 50 in 2008.
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ACTIVITIES 1-1Conduct base-line survey to identify causes of defaulter cases. 1-2. Interview questionnaire to TB patients families to identify their knowledge on TB. 1-3Conduct advocacy meetings with stakeholders. 1-4. IEC materials developed distributed. 2- Develop supervisory guidelines. 2-3 Conduct workshop with HWs. 2-4 Conduct one day seminar every month. 2-5 Trainings conducted. 3- Directory furnished. 3-1 Monthly meeting with DC TC. Inputs Personnel long term expert, project leader, project co-ordinator. Short term experts as required. Equipment vehicle, maintenance parts, POL and spare parts. Training material and IEC materials. Funding of workshops and meetings. Training facility Local cost. Facilities like DHDCoffice Trained workers continue to work for their facilities.
ACTIVITIES 1-1Conduct base-line survey to identify causes of defaulter cases. 1-2. Interview questionnaire to TB patients families to identify their knowledge on TB. 1-3Conduct advocacy meetings with stakeholders. 1-4. IEC materials developed distributed. 2- Develop supervisory guidelines. 2-3 Conduct workshop with HWs. 2-4 Conduct one day seminar every month. 2-5 Trainings conducted. 3- Directory furnished. 3-1 Monthly meeting with DC TC. Inputs Personnel long term expert, project leader, project co-ordinator. Short term experts as required. Equipment vehicle, maintenance parts, POL and spare parts. Training material and IEC materials. Funding of workshops and meetings. Training facility Local cost. Facilities like DHDCoffice Pre-conditions The NTP and CIDA support the project.
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Thank you