Enhancing interactions between medical institutions on prevention and treatment of patients with dua

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Enhancing interactions between medical
institutions on prevention and treatment of
patients with dual infections (Tuberculosis HIV)
Vadim Seledtsov
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Introduction

• Two vertical institutions HIV and TB
• Two strategies two programs
• There were no mechanisms for interactions
  developed between HIV/AIDS and TB medical
  institutions
• No protocols regarding communication between
  medical institutions and on treatment of patients
  with dual infection
• Urgent staff need, especially those trained for
  the purpose of taking care of patients with dual
  infection
• No monitoring protocols

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Introduction (2)

• A model project on prevention and treatment of
  patients with dual infection was developed aiming
  at improving interactions between TB and HIV/AIDS
  institutions as well as
• reaching high coverage of vulnerable populations
  
• Holding the HIV/TB disease rates at the current
  levels
• Improving access to HIV/AIDS services.

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Goals and objectives

• Goal
• Improving interaction between TB and HIV
  institutions
• Objectives
• Developing and implementing main activities
  within the scope of the project
• Monitoring and evaluation of the results of the
  project
• Finding out major issues and problem sites
• Analysis of the monitoring data
• Creating recommendations.

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Project implementation
Unified Interaction Program
Interaction Mechanism
PLHIV TB/HIV patients at HIV/AIDS
institutions
Joint Technical Working Groups, treatment
protocols, referral systems, registration forms
TB patients TB/HIV patients at TB medical
institutions
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Work Plan

• Needs assessment
• Setting up a coordination group the Technical
  Working Group
• Joint Work Plan for the project implementation
  (HIV/TB program)
• Developing materials for trainings and ME
  (indicators,forms, etc.)
• Developing a Pool of Trainers
• Training of specialists

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Work Plan (2)

• Developing a Group of ME specialists
• Monitoring of activities and making necessary
  updates
• Finding out problems and issues
• Project evaluation
• Developing of necessary recommendations
• Scale-up

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TWG responsibilities

• Needs assessment
• Developing the joint work plan (pilot sites
  identification)
• Developing a referral system for patients
• Developing treatment protocols, studying programs
  as well as indicators and necessary forms for ME
• Assisting in training of specialists

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TWG responsibilities (2)

• Analyzing the results of the project on a
  quarterly basis
• Creating necessary recommendations
• ME
• Making necessary updates
• Creating recommendations for scale-up

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Trainers responsibilities

• Developing of a study-program and materials on
  TB/HIV according to the recommendations of the
  TWG
• Training of specialists
• Consulting TWG and other specialists
• Creating reports for TWG

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Responsibilities of the ME specialists

• Conducting a baseline and an end-line evaluation
  
• Conducting regular monitoring on a quarterly
  basis
• Monitoring of patients registration
• Gathering data
• Identifying issues and problem sites
• Providing consultations to specialists at the
  sties
• Creating reports for the TWG on the results of
  the monitoring
• Implementation of the recommendations of the TWG
  on the results of ME
• If necessary consulting the TWG on making
  updates on the registration forms

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Results

• TWGs were set up in all countries
• A package of necessary documents was prepared,
  including country orders on enhancing
  activities on HIV TB control in patients with
  dual infection
• Trainers on TB/HIV were trained
• More than 500 specialists were trained
• ME specialists on TB/HIV were trained
• ME specialists conduct regular monitoring

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Results (2)

• More that 150 institutions were covered by
  planned activities registration and treatment of
  patients was adopted and implemented at sites
• More that 2,000 patients received medical
  services within the pilot project
• The results of the project were analyzed and
  recommendation were given for scale-up
• Possibility for continuous development for
  specialists on TB/HIV was ensured curriculum
  incorporated into university programs.

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Recommendations

• The two services are to maintain constant
  interaction between each other
• mutual information communications
• joint monitoring of patients registration and
  treatment
• conducting regular joint meetings on a quarter
  basis.
• Include basic indicators on TB/HIV into the
  national monitoring system.

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Recommendations (2)

• Conduct regular trainings for medical nurses,
  general medical specialists, laboratory workers,
  narcologists, STI specialists as well as
  conducting trainings for TB specialists on how to
  perform VCT.
• Develop an information campaign for the general
  public on decreasing stigma and discrimination
  against PLHIV.

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Recommendations (3)

• Consider ways of enhancing resources for
  providing medicines, laboratory equipment,
  individual means of protection as well as
  providing patients with education materials and
  counseling.
• Work cooperatively, plan necessary expenses from
  government and external international
  organization and donors.

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Summary

• The developed mechanism on interaction of the two
  services (TB HIV) was recommended for scale-up.
  
• Independence of the two services as well as their
  mutual interaction can
• Guarantee provision of necessary medical services
  to patients with dual infection
• Stimulate the best results in activities aimed at
  controlling each of the two infections (TB and
  HIV)
• Create best access of patients with dual
  infection to medical services.

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Thanks to all!