Implementation and results of the model on interaction of AIDS and TB services in Dushanbe city

1
Implementation and results of the model on
interaction of AIDS and TB services in Dushanbe
city

• Mansur Dodarbekov
• Republican AIDS Center of Tajikistan
• Member of TWG on TB/HIV

2
Model on interaction of services

• Goal
• Testing of pilot project on establishment of
  interaction between services to
• assess its effectiveness
• conduct analysis
• identifying problem areas
• development of recommendations on further
  expansion of the model

3
Model on interaction of services

• Objectives
• Create opportunities for interaction of services
• Introduce developed complex of project activities
• Evaluate model implementation results
• Determine problem areas
• Conduct analysis
• Develop recommendations

4
Preparatory stage

• Expertise, needs assessment
• Identifying the pilot region for implementation
  Dushanbe
• Working meeting with key partners (August 2005)
• Establishment of TWG (22 specialists)
• Development of interaction plan of AIDS and TB
  services
• First TWG meeting (August 2005)
• Development of protocols and recommendations on
  management of patients with TB/HIV and services
  interaction
• Creation of monitoring protocol, tools and
  indicators of monitoring and evaluation

5
Preparatory stage

• Training of the national team of trainers on
  TB/HIV issues (September 2005)
• 26 specialists trained
• Created national team of trainers (6 persons)
• Orientation meeting for heads of treatment
  facilities of Dushanbe city
• Discussion of issues on planning joint activities
  on model implementation

6
Preparatory stage

• Issued Prikaz of the MoH roundtable On
  strengthening ability to combat HIV/TB dual
  infection in the Republic of Tajikistan (? 572
  from 24.10.05)
• Training of specialists
• 142 specialists trained on interaction of the
  services and management of patients with dual
  infection
• 26 specialists trained on ME
• Created the national ME team (6 persons)

7
Implementation of model

• The following facilities were involved into
  implementation of model
• Republican AIDS Center
• City TB Center
• Republican Clinical TB Hospital
• DOTS rooms of City Health Centers 2, 3, 4, 8,
  10, 11, 12

8
Implementation of model

• VCT is introduced into TB service

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Model implementation results

• Established interaction between services
• Coordinating body Thematic Working Group was
  established
• The essential package of documents developed
• The national team of trainers was build up
• Specialists were trained
• Specialists register and manage patients
• ME team conducted monitoring
• Pilot facilities covered by planned activities
• More than 500 patients received services

10
Some indicators of TB/HIV services interaction
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Model implementation results

• Developed recommendations on further expansion of
  the model
• Ensured political support of the component
  issued Prikaz of MoH on strengthening ability to
  combat HIV/TB dual infection
• Ensured opportunity for continuous training on
  HIV/TB issues component introduced into training
  process of Tajik State Medical University and
  Medical Postgraduate Institute of Tajikistan

12
Model implementation results

• TWG on TB/HIV included into TWG on Treatment,
  Care and Support as sub-group
• Team of trainers is a good resource for further
  training of specialists throughout the country
• Developed package of documents is used in
  Tajikistan
• TB/HIV included in the National AIDS program
• TB/HIV component was included in Round 6 of the
  Global Fund and is implemented in the country

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Other activities

• Round table on sustainability issues of services
  interaction at the city level
• Prikaz of City Health Department
• Training on VCT for TB specialists
• Interaction model at City Health Center 10
• Round table on role of NGOs in interaction of
  services
• Development of IEC material for patients and
  health care staff jointly with Project HOPE

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Model expansion

• Expansion of the model on services interaction in
  Round 6 of the Global Fund
• Developed National Strategy on TB/HIV
• Oblast level trainings for TB specialists,
  including paramedical staff
• TB service provided with 4 IFA devices
• Laboratory specialists were trained.

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