Carmelia Basri, NTP Indonesia

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Increased Complexity for Comprehensive TB
Control Indonesia Experience

• Carmelia Basri, NTP Indonesia
• Mega Meeting, Versailles 16 Oct 2005

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Systematic presentation

• Situation and Goal
• HRD TB strategies
• TB Expansion and HRD
• Current Challenges
• Strategies and Next Steps
• Conclusions

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Situation and Goal
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DOTS ServicesPopulation 220
MillionNo. Provinces 33No.
District/Municipalities 445
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Our HRD Goal in TB control
Availability of competent staff/ personnel - in
the the right number, - with appropriate skills
(KAP), - at the right place and - at the right
time to enable the achievement of goals of the
NTP
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HRD TB strategy
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Training Cascade
NTP Manager
Curricula, Modules, Facilitator and Training Guide
Mater Trainers
NTC as HRD Focal Point
4 Regional Training Center (RTC) for TOT
RTC
RTC
RTC
RTC
PTC as HRD Focal point
PTT
PTT
PTT
PTT
PTT
PTT
PTT
PTT
Provincial Training Team and Supervisors
PTT
PTT
PTT
PTT
Health Service Unit (Health Centers, Lung
Clinics, Hospitals, etc.)
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Training Time Frame

• 1999 - 2000 Preparation phase
• Development 5 Year Strategic Plan Plan for
  Capacity Building
• Revision of Guidelines Training Modules,
  Training Master Trainers
• 2001 2003 DOTS Acceleration
• 100 Provincial and District staff
• gt 90 HCs and
• 100 Lung Clinics

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Training Time Frame (2)

• 2003 2008 Quality DOTS Expansion
• Intensify HCs
• Involving Hospitals and PPs, Workplace,
  Prisons, Non-MoH health facilties, (Military,
  Police, Govt enterprise etc)
• NGOs, Medical Schools, Nursing Schools, PH
  Schools etc
• 2008 onwards DOTS Sustainability
• Maintenance of the covered

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DOTS Expansion and HRD
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DOTS Expansion and TB Training
Other training
ACDA
Stepwise Training in 4 Regional Training
Centers MT
Hospital Training
CDR
PTC
PTO
PPO
HRD Program with Dutch support
HCs Training
Gerdunas founded
USAID CIDA start-up
GFATM start-up
ISAC Start-up
First Partnership Meeting
5-YS plan
GDF
Restructuring Gerdunas
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Comprehensive of TB Control
Principle Expansion without reducing
quality Consequence Need more activities, more
staff, more training, and more partnerships

• Need more staff
• PTC (Provincial Training Coordinators)
• PTO (Provincial Technical Officer)
• PPO (Provincial Program Officer
• ME (data officer)
• Strengthening HRD - TB
• Advanced Course for DOTS Acceleration (ACDA)
• Supervisor Plus Course (supervision skills)
• TB Logistic Management Course
• Management course

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Comprehensive of TB Control
Principle Expansion without reducing
quality Consequence Need more activities, more
staff, more training, and more partnerships

• More Collaboration
• Basic curricula TB curricula and Modules for
  Medical School, Nursing School, etc.
• NGO involvement
• Collaboration TB Leprosy, TB HIV

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Trained Health Center Staff per Provincemid 2005
Medical Doctors
Paramedics
LEGEND Trained to Standard
lt 50 50 80 81 100 gt 100
Lab Technician
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Current Challenges
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Current Challenges (1)

• Managemant skills (including HRM) still
  inadequate
• High Turn-Over of staff
• Some training ís sub optimal
• Private Sector needs
• Number of Medical-, Nursing, Public Health
  schools and NGOs involved in DOTS is still low.

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Current Challenges (2)

• High Training needs in hospitals
• Post training evaluation still unstructured /
  sub-optimal
• Supervision skills often still inadequate
• New training needs e.g. TB-HIV, TB for NGOs,
  DOTS plus, etc.
• Commitment donor dependence, retention of staff

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HRD Strategies and Next Steps
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Strategies and Next Steps

• Curricula, modules, need to be adjusted to
  accommodate current issues
• Workshops for Supervisors ? continuous training
  to increase competence
• Strengthening Provincial Facilitator teams
• Stepwise Hospital training
• Expansion of ACDA (Adcanced Course for DOTS
  Acceleration)
• Socialization TB DOTS materials to all Medical,
  Nursing, Public Health schools
• Amend HRD-TB strategic plan, including current
  issues.

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Conclusion
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Conclusion

• Increasing complexity / comprehensiveness the
  more work for HRD-TB
• Improvement of quality and performance of TB
  program requires more HRD-TB
• HRD needs long term planning and management