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World TB Day 2010









 

 

 
About NTP

Pakistan became a sovereign state in 1947 and its present projected population is estimated at 151 million, spreads over an area of 852392 sq km. The population growth rate is 2.5 % life expectancy is about 63 yrs and the average literacy rate is 50 %. Per capita income is US $ 492. Health expenditure (public sector) is 0.08 % while total health sector investment is 3.9 % of GDP.

Administratively Pakistan comprises of four provinces besides some Federally Administered Areas and the state of Azad Jammu and Kashmir. The country has a mixed society, which is predominantly Muslims. Urdu is the National language while multiple regional languages are spoken in the country; however, English is used for most official purposes. Each province/area is divided into districts, which are the basic administrative units.

 
Burden of TB
 
WHO declared TB a global emergency in 1993. Since then efforts have been made to expand partnerships and bring all stakeholders on board in order to control this disease more effectively. The economic conditions correlate with new cases of TB. The highest incidence is seen in those countries of Africa, Asia, and Latin America with the lowest gross national products. WHO estimates that eight million people are infected with TB every year, out of those 95% live in developing countries. An estimated 3 million people die due to TB every year.
TB has been prevalent in Pakistan and unfortunately it has been one of the neglected health areas in the past. Pakistan ranks 6th amongst the countries with a highest burden of TB in the world. Pakistan contributes about 44% of tuberculosis burden in the Eastern Mediterranean Region. According to WHO, the incidence of sputum positive TB cases in Pakistan is 80/100,000 per year and for all types it is 177/100,000.TB is responsible for 5.1 percent of the total national disease burden in Pakistan. The impact of TB on socio economic status is substantial.
The Early Years
 
Government of Pakistan endorsed the DOTS strategy, following WHO’s declaration of TB as a global emergency in 1993, The National TB Control Programme (NTP) Pakistan adopted DOTS (Directly Observed Treatment, Short course) strategy in 1995. The national guidelines were developed and few pilot projects were also started. However, the program became dormant due to abolition of the Federal Directorate for Tuberculosis Control in 1996. therefore the progress during the first three years (i.e. 1995 – 1998) remained slow, because of its vertical approach, lack of consensus between federal and provincial units, and non-availability of funds from regular health budget. In 1998 the roles and relationship between the federal and provincial tuberculosis control program were re-defined and agreed.
 
ROLE OF NTP IN EARTH QUAKE AFFECTED AREAS
 

National TB Control Program after the devastation created by Earthquake deputed officers for establishing coordination mechanism for services and logistics among MoH , NGOs, Army and District authorities and provided administrative and Technical support to DHQ Bagh and functionalized AIMS Hospital Muzaffarabad in coordination with MoH. NTP also provided, tents bedding, transport, medicines and food to TB staff and general public.

A survey was conducted by the National TB Control Programme Officers (NPOs) in collaboration with WHO, to assess the status of the PHC network in the earthquake-affected areas two weeks after the earthquake. The objectives of the survey were:

1. To assess the status of the PHC network in the earthquake-affected areas, including TB DOTS services
2. To set up a plan of action to restore the PHC network in the districts affected by the earthquake, and
3. Assess the presence of relief NGOs providing health care in the field in terms of identification, type of services provided and quantification of population covered by their services

NTP provided assistance for management of ARI in the disaster areas. Cluster Survey in Rawalpindi/Islamabad camps and hospitals for retrieval of TB cases was conducted and treatment provided to the retrieve patients. A separate desk in TB center, Rawalpindi has been set up to register earth quake affected, TB patients. NTP acquired additional ATT drugs for 5000 patients from GDF and has submitted proposal to (GFATM) for 200,000$ for revitalization.

Health Facilities functionalized and supplies provided
 

AJK: 30 Health facilities functionalized 31 tents and furniture, 4 generators, 15 microscopes and drugs for 4000 patients.

NWFP: 11 health facilities functionalized 37 tents and furniture 4 generators, 19 Microscopes and drugs for 1500 patients.

 
Future Plans
 

• Rehabilitation/ Reconstruction of PHC/TB network
• Provision of prefabricated containers
• Field supervision visits to verify quality of services
• Health education campaign among the community
• Establish a referral system between field hospitals/ camps and PHC/TB facilities
• Default tracing mechanism

 

 
   
   
   
   
 
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