1

Dr Carmelia BasriDr Nadia Tarmizi

National TB Control Program Indonesia

M&E WORKSHOPMEASURE Evaluation, New Delhi, 1Feb2006

Indonesia : 22 High Burden Countries

Indonesia : 22 High Burden Countries

1. India2. China

3. Indonesia4. Bangladesh5. Nigeria6. Pakistan7. South Africa8. Philippines9. Russia10. Ethiopia11. Kenya12. DR Congo13. Viet Nam14. UR Tanzania15. Brazil16. Thailand17. Zimbabwe18. Cambodia19. Myanmar20. Uganda21. Afghanistan22. Mozambique

Indonesia 10%Indonesia 10%Indonesia 10%Indonesia 10%

Bangladesh 4%

China15%

China15%

India30%India30%

Other28%

Philippines 3%

Pakistan 4%

Nigeria 3%

South Africa 2%

Russia 1%

Chronology of events leading to rapid scaling up of DOTS

CD

R

0

10

20

30

40

50

60

1998 1999 2000 2001 2002 2003 2004

Gerdunas* established

First PartnershipMeeting

HRD Program(Dutch) Started

Stepwisetraining

5YSP

GDF

GFATM Prop

TB PartnersForum

TBCTACIDA

start-up

GFATMstart-up

ISACStart-up

HospitalDOTS

*Gerdunas = National Integrated

Movement to Fight against TB

Health Service Unit Total Involved in DOTS

Health Center

Lung Clinic

Lung Hospital

District Hospital

Provincial Hospital

Army Hospital

Private Hospital

Police Hospital

Private Practitioner

7.356

34

9

340

70

65

724

35

7200 (>98%)

34 (100%)

9 (100%)

85 (25%)

14 (20%)

20 (28%)

95 (12%)

5 (15%)

??? (piloting 5 provinces)

DOTS ServicesPopulation 220 Million

Provinces 33District/Municipalities 445

42%

28%

54%

35%

0

100

200

300

400

500

600

Sm

ear+

pre

vale

nce/1

00K

1980 survey 422 255 433 321

1990 311 146 342 217

2004 survey 203 67 246 125

Sumatra Java-Bali KTI (East) National

PREVALENCE Survey 2004

6

38

60

48

31 3336

42 42

28

62

78

61

42

66

5156

37

16

41 4137

22

66

46

53

47

62

43

27

40

0

10

20

30

40

50

60

70

80

90

Nan

gg

roe A

ceh D

arussalam

No

rth S

um

atera

West S

um

atra

Riau

Jamb

i

So

uth

Su

matera

Ban

gka B

elitun

g

Ben

gku

lu

Lam

pu

ng

Ban

ten

DK

I Jakarta

West Java

Cen

tral Java

DI Y

og

yakarta

East Java

Bali

West N

usa T

eng

gara

East N

usa T

eng

gara

West K

aliman

tan

Cen

tral Kalim

antan

So

uth

Kalim

antan

East K

aliman

tan

No

rth S

ulaw

esi

Cen

tral Su

lawesi

So

uth

Su

lawesi

So

uth

East S

ulaw

esi

Go

ron

talo

Malu

ku

No

rth M

aluku

Pap

ua

160 210107

64

working estimates of incidence to be applied at provincial level.

Case Detection Rate 2004

CDR-2004 (Adjusted Incidence)

29.157.5

43.729.0

40.737.1

43.941.7

27.258.4

68.953.9

41.164.1

43.251.4

33.933.7

38.522.7

69.758.8

36.247.6

37.932.7

23.125.2

32.738.4

54.2

0 20 40 60 80 100 120

NAD

SUMUT

SUMBAR

RIAU

JAMBI

SUMSEL

BABEL

BENGKULU

LAMPUNG

BANTEN

DKI

JABAR

JATENG

D. I . Y.

JATIM

BALI

KALBAR

KALTENG

KALSEL

KALTIM

SULUT

GRTALO

SULTENG

SULSEL

SULTRA

NTB

NTT

MALUKU

MALUT

PAPUA

INA

CDR-2004 (National Incdnc 115)

40.580.0

60.840.4

56.651.6

61.158.0

37.854.3

64.150.2

38.335.7

40.262.061.5

70.441.4

127.2107.4

66.186.9

69.328.6

59.842.2

46.159.7

70.251.8

0 20 40 60 80 100 120

NADSUMUT

SUMBARRIAU

JAMBISUMSELBABEL

BENGKULLAMPUNG

BANTENDKI

JABARJATENGD. I . Y.JATIM

KALBARKALTENG

KALSELKALTIMSULUT

GRTALOSULTENG

SULSELSULTRA

BALINTBNTT

MALUKUMALUTPAPUA

INA

9181

54 5850

87 86 86.3 87

1.44.6 7.5

1219 20 21

29

38

54

0

20

40

60

80

100

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Year

SR (%

)

0

10

20

30

40

50

60

CDR

(%)

SR CDR

128 128.7127

126

122

118

115

110

107105

110

115

120

125

130

1997 1998 1999 2000 2001 2002 2003 2004 2005

Incidence, NewSS+/100,000

100,210

74.738

53.96552.33849.333

29.78125.420

174,188

152.200

93.038

84.591

73.435

39.55733.216

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

1997 1998 1999 2000 2001 2002 2003

Kasus TB Baru BTA(+)

Semua tipe

Program performance and

epidemiologic impact

…road to reach the Global Target by 2005

WHO Global TB Report 2005

40

50

60

70

80

90

100

0 20 40 60 80 100

Case Detection Rate (%)

Su

cces

s R

ate

(%)

TARGET ZONE

20032002

2001

2000

2004 2005

Progress in 2002-2003

Progress in 2001-2002

Progress in 2000-2001