Sudan: National Partnerships to Stop TB

Dr. Amgad Faried On Behalf of:STPANTP; Dr. Alsadig YousifEpi Lab; Prof. Asma Elsony

Local Mile Stones

1940s1940s 2 Sanatoria: Abu Anga & River Hospital.2 Sanatoria: Abu Anga & River Hospital.

19561956 11STST Tuberculin Survey Tuberculin Survey

19741974 Program commenced based on “Hospital Program commenced based on “Hospital departments”departments”

19761976 2nd Tuberculin survey2nd Tuberculin survey

19861986 3rd Tuberculin survey3rd Tuberculin survey

1989-19901989-1990 WHO and IUAT-LD formal reviews of NTPWHO and IUAT-LD formal reviews of NTP

19911991 Manual prepared in collaboration with IUATLDManual prepared in collaboration with IUATLD

19931993 Pilot ProjectPilot Project

19941994 Central Unit was formed under the lead of ElsonyCentral Unit was formed under the lead of Elsony

20042004 2nd in depth review by IUATLD, WHO and LHL2nd in depth review by IUATLD, WHO and LHL

Experiences worldwide have shown that

TB control requires a strong and sustained coordinated efforts of many stakeholders

Need for involving the public

Getting more commitment Mobilizing more resources Increasing the accessDeveloping more appropriate applicable

tools

NTPNTP EPI-LABEPI-LAB

STBPASTBPA

STOP STOP TB TB

PARTNERSHIPPARTNERSHIP

Stop TB board is formed

And P. Gasim BadriP. Gasim Badri is appointed as TB Ambassador.

Our local partnership aims to achieve the same objectives addressed by the MDGs:

1. By 2015: The burden of TB disease (deaths and prevalence) will be reduced by 50% (compared with 2000 levels)

2. By 2050: The incidence of TB disease will be less than 1 per million population

Strengths– Partnership established and Functioning–Clear TOR–Stakeholders Involved (STPA)

Weakness–Lack of baseline Data–Lack of M & E –Indicators

Opportunities–Full autonomy of the partners.

Threatens–Poverty–Risk of overburdening NTP–Sustaining funding–Dependency

Achievements

1. DOTS committees 1702. Universities out reach 19 3. Schools out reach 3004. TB in workplaces 175. TB in prisons 276. TB in forth defense (Police and army) 377. STP handbook translated and being

evaluated by stake holders.

Plan of implementation of DOTs committees

Central UnitCentral Unit

300 TBMUs300 TBMUs

900 DOTs Centre900 DOTs Centre(3 for each TBMU)(3 for each TBMU)

900 DOTS committees 900 DOTS committees EACH CONSIST OF 3 PERSONSEACH CONSIST OF 3 PERSONS

STPA

Composed of TB patients and other members, aiming to involve TB patients in the social life to try combating the social stigma caused by TB disease.

The association aims to convert wrong beliefs, negative attitudes and behavior towards TB patients. In addition, the association is trying to encourage positive behavioral changes in societies and communities, especially in rural, and nomad populations.

STPA has 18 branches covering more than 80% of the TBMUs

The association works mainly in raising awareness through health education of TB patients, families and communities, in coordination with national and international groups of the same objectives.

The association established its work to make TB patients central in the decision-making process concerning health care financing, provision, and quality of provided services.

Social Survey

STPA conducted an assessment survey to collect information about the current status of TB patients and the types of social obstacles facing them.

The study was conducted in areas targeted by the association to form a baseline for the ongoing activities and interventions carried out by the association and similar organizations. Furthermore, areas not covered by the association have been selected for assessing survey variables.

Health Education

STPA is carrying an ongoing health education courses for its members. In 2006 it conducted 12 courses both in Khartoum and other states.

Advocacy activities, role plays, songs, home visits, group discussions, public lectures and symposia were also addressed via 19 health education programs conducted within 2006 in 15 states of northern Sudan.

STPA also conduct series of lectures for the IDP In their camps in 4 states.

STPA has also established a program of information messages aiming to change patient behavior through guidance messages and educational interaction.

TB patients working groups Project

STPA launched a program of “TB patients working groups” which aims to obtain an in-depth understanding of the social and psychological factors contributing in the spread of tuberculosis and adherence to treatment.

The program is getting these information from the TB patients themselves.

It is also aiming to involve TB patients in solving these problems through focused discussion and formulation of relevant and applicable recommendations.

Rahma Fund Project

Is a new initiative project of STPA aiming to improve the economic status of its members (TB patients) and to lessen the dependence among them.

Revolving fund loan is offered to the patients to finance small income generating projects for the poor patients’ families.

NTP

Since its establishment in 1994, SNTP contribute in management of more than 250,000 patient.

It covers 24 states with population coverage of 100%.(geogaphical coverage is still under processing)

About 11.300 new cases are enrolled in the TBMUs annually

Political instability Is a major constrain for the program to cover some areas of Sudan.

Case Finding of the NTP

4800520056006000640068007200

2003 2004 2005 2006 2007

Epi Lab

Epi Lab is a Public Health outreach research centre taking the duty of Support and Evaluation.

The advance research experience of the Epi Lab as a national centre of competence is utilized to Support And Guide the work by addressing issues other than field work. (academia, developing new approaches, evaluation, and cost-effectiveness).

Running a wide nation program without regular evaluation and Support by research work is not effective and may be even be harmful.

STP Hand Book

The hand book is translated to Arabic in order to distribute it for an evaluating sample.

This sample composed of:– 100 TB patients.– 100 medical Students from 4 universities

(Khartoum, Juba, Aljazeera, AMST)– State coordinators

A structured evaluation questionnaire is formed to be distributed with the handbook.