ACS strategy Indonesia - Strategy... · Puskesmas Priv Pract Gov Hosp Priv Hosp Midwife Self-treatm

download ACS strategy Indonesia - Strategy... · Puskesmas Priv Pract Gov Hosp Priv Hosp Midwife Self-treatm

of 23

  • date post

    09-Mar-2019
  • Category

    Documents

  • view

    213
  • download

    0

Embed Size (px)

Transcript of ACS strategy Indonesia - Strategy... · Puskesmas Priv Pract Gov Hosp Priv Hosp Midwife Self-treatm

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Advocacy, Communication &Advocacy, Communication &Social Mobilization StrategySocial Mobilization Strategy

IndonesiaIndonesia

Carmelia BasriYoana Anandita

National TB Control Program Indonesia

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Chronology of Events leading to rapid Chronology of Events leading to rapid scaling up of DOTSscaling up of DOTS

0

10

20

30

40

50

60

1998 1999 2000 2001 2002 2003 2004

Gerdunas established

First Partnership

Meeting

HRD ProgramDutch Started

CD

R

Stepwisetraining

5YSP

TBCTACIDA

start-up

TB PartnersForum

GDF

GFATMstart-up

ISAC

Start-up

Launched 24 March 1999 by Launched 24 March 1999 by MOH (President support)MOH (President support)

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

TB Gerdunas Structureand Organogram

National Committee (Komnas)

Minister of Health

Technical Advisory Committee (Komli)

DG of CDC&EH/Director of Gerdunas TB

Director DTDC /Deputy Director Gerdunas TB

NTP Manager / Executive Secretary of Gerdunas TBC

TB Team

Partners Techn (WHO, KNCV) Financial (GFATM, USAID, CIDA, KNCV etc)

TB Partnership Forum

Working groups:

PPM, HDL, Lab/DRS, ACS, TORG, Paediatric, HRD, TB/HIV, Logistic

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Towards 70% case-detection

66.1

49.4

41.9

14.310.7 8.9

0

10

20

30

40

50

60

70

80

Puskesmas Priv Pract Gov Hosp Priv Hosp Midwife Self-treatm

SumatraJava-BaliKTINational

Health-seeking if having TB symptoms

population has intention to go to

Indonesians when sick go to Puskesmas (60%-urban and 70% rural) TB services are available and 'gratis'BUTBUT:

Perception population= puskemas are for poor Treatment seeking to services regional differences Weak ACS capacity at province/ district level

We need to build capacity of DOTS teams to promote TB services

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Successfully treatedIndonesias TB program has high success-rates since 2001 (85%)

BUTBUT: Drop-out within 2months after feeling better High drop-out rate in hospitals (up to 60%) Few tools available for education, social mobilisation

Need to do a better job in :informing patients, linking treatment follow-up, mobilising Treatment Observer (community-based groups)

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Success Rate by province 2002-2003

85,7%

61,4%

66,7%69,0%

75,7%

77,9%

79,6%

82,3%83,2%

83,5%

84,9%

86,1%

86,9%87,1%

88,1%

88,2%

88,5%

89,2%

89,2%91,9%

92,5%

92,7%

92,8%

93,1%94,4%

94,7%

94,8%

96,1%

96,6%96,9%

97,2%

88,9%90,3%

85,2%

79,2%

67,0%

89,7%95,9%

71,9%

86,2%

94,3%

79,0%89,3%

85,6%

89,8%

88,8%

89,2%

84,8%85,2%

95,4%

93,4%

92,5%

76,2%84,4%

94,7%

92,9%

95,8%

85,9%82,3%

97,0%

86,2%

93,8%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

INDONESIA

NAD

DKI JAKARTA

PAPUA

NTTMALUKU

JAWA TIMUR

JAMBI

JAWA TENGAH

SULSELRIAU

D. I . Y.

BABEL

SUMSEL

KALTIM

SUMBARNTB

KALBAR

JABAR

SULUT

BANTENKALSEL

KALTENG

MALUKU UTARA

LAMPUNG

BALISULTRA

SUMUT

SULTENG

GORONTALO

BENGKULU

20022003

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Key Recommendations: MOHKey Recommendations: MOH(External Monitoring Mission, March 2005)(External Monitoring Mission, March 2005)

1. Expand DOTS in a quality manner to the hospital sector, with special attention to referral & the linkages

2. Strongly advocate with provincial and district governments to allocate sufficient funds to meet and maintain minimum service standards (SPM) in light of potential phasing out of external funding

3. Encourage local governments to establish provincial DOTS teams and re-vitalize the local Gerdunas in order to enhance linkages with other sectors and widen the resource base for long term sustainability

4. Strengthen the links between laboratory services and the TB programme at all levels

5. Urge FDA and DG of Pharmacy to ensure that locally produced anti-TB drugs meet international quality standards

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

TFA-ACS Mission Recommendation22-31 Agst 2005

1. To fully implement the Strategy Framework on ACS, it is recommended that there be an enhancement of the human resources for ACS available to the NTP.

2. Policy advocacy efforts be enhanced to include ongoing education initiatives aimed at policy-makers and others of influence at the provincial and district levels

3. The Conceptual Framework needs be completed to ensure that appropriate baseline data are established and measurable objectives and indicators are developed

4.5. etc to 8

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Knowledge about TBKnowledge about TB

0

10

20

30

40

50

60

70

80

90

Heard/TB TB Curable TB/ secret Free srvcs

62.6

51.1

43.4

12.6 15.6

1.1 1.1

0

10

20

30

40

50

60

70

Food/Drinks TB cough Airpollution Inherited Other Spell/magic Hit chest

SumatraJava-BaliKTINational

58.1

66.1

35.7

1620.5

11.414.2

9.9

3.69.7

13

8.1

13.8

35.6

46

56.2

0

10

20

30

40

50

60

70

Friend/family

TV Healthofficer

Radio Magz/newsp

Relig/ commleader

Teacher Poster/leaflet

NationalUrbanRural

Source of TB informationSource of TB informationUrbanUrban--Rural differencesRural differences

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

ACS FrameworkGoal: Achieve high political commitment through TB advocacy and strengAchieve high political commitment through TB advocacy and strengthening thening

of of GerdunasGerdunas and partnerships and partnerships Create informed demand through improved patientCreate informed demand through improved patient--education and education and

community participation community participation

Objectives:1. Political commitment: District governments are committed to increase

funding/ budget allocations for TB control.2. Informed Demand: Increase the number of TB patients seeking and

completed the treatment with appropriate support and care (Tx obsvr).3. Healthcare provider capacity: Equip health providers and outreach

workers to effectively communicate about TB control and promote DOTS4. Supporting society: Increase public support and resources through

revitalized Gerdunas5. Research & MIS: Establish an evidence base to support, plan, monitor, and

evaluate advocacy and communication programs.

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

Advocacy, Communications, Social Advocacy, Communications, Social MobilisationMobilisationStrategic FrameworkStrategic Framework

TB Goals 05/15Case-detectionCureMDGs

Social/ Political Environment Low Health/ TB awareness, investment, budget allocation

Advocate political commitment

Service Delivery System Low ACS capacity, tools/ educational materials Community support potential

Healthcare provider capacity

Community and Individual Lack of public involvement for appropriate treatment seeking Lack of patient knowledge for treatment success (esp. hospital)

Informed demand

Advocacy, com

munication,

Social mobilisation

Strategy

Research and M

IS: Baseline data (K

AP

, research), P

lanning, managem

ent, and M

onitoring and Evaluation

Supporting Society: Gerdunas, partnerships,

comm

unity based DO

TS

Advocacy, Communication, Social Mobilization StrategyINDONESIA ACS Working Group Meeting,Mexico, 13-16 Sep 2005

1. Political CommitmentDistrict governments are committed to increase funding for TB control leading to increased budget allocations.

Activities1. District campaign in 15 district