strengthening sme system for national programmes moving from transmission reduction to elimination...
TRANSCRIPT
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Strengthening SME system for national programmes moving from transmission
reduction to elimination phase
Cambodia
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Pailin Province- Capital: Pailin- Area: 803Km²- Total Pop: 102382- PAR: 74,124- 2 Administrative Districts- 1 Operational District- 4 Health Centers- API/1, 000: 5.04 (#374)- In western- northern, Border of Thailand
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1. SME system and update
• PM endorsed National Strategic Plan for Malaria Elimination ( 2011- 2025)
• Strong commitment from Provincial Governor and Community participated
• Adequate health infrastructure • Established provincial malaria elimination
committee • Functional partnership
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• Shortages of public health staff• Inadequate capacity building• Inadequate curative and preventive services
for MMP
1. SME system and update (cont.)
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2. Develop / update relevant guidelines including SOPs
- National Strategic Plan for Malaria Elimination 2011-2025 (already endorsed and being implemented)
- Malaria Elimination Action framework ( MEAF) 2015-2019 (under development)
- SOPs for PCD and ACD (as a part of the new framework to be revised)
- Develop SOPs for Foci identification and investigation and response, QA diagnosis, data management and reporting and supervision for elimination phase
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3. Job description for surveillance workersHealth Center:
– Case detection– Treatment– Follow up– Jointly with OD surveillance officer – case and foci
investigation– Reporting of cases and stock of commodities
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3. Job description for surveillance workers (cont.)
Operational health district (OD):– Case detection– Case investigation– Foci investigation and Response– Analysis of data and feedback to HC– Collect data from private sector– Data entry– Reporting of cases and stock of commodities– Supervision
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3. Job description for surveillance workers (cont.)
Provincial health department (PHD):– Case detection– Jointly with OD surveillance officer – case and foci
investigation and response– Outbreak investigation and Response– Data entry– Analysis of data and feedback to district – Supportive supervision– Communication with all sectors (meeting, advocacy)
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HC OD PHD CNM
8 additional Staff * (Request MoH)**
6 additional staff * ** (3 group)2 in each group(Contract staff)
2 additional staff* (contract staff)***
5 additional**- 2 Data entry
specialist- 3 staff (Epi-
Unit )(Request MoH)
Human resource needed
Number of HC will be specified*Job description will be done in line with government’s policy for those to be recruited by MoH** Job description will be done in line with special requirements by CNM and international partners***
4. Human resource planning
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Training, supervision, motivation
• Training: planning exercise to prepare plan with existing human resources, gaps and needs
• Supervision: guidelines, schedule, checklist, supervision team
• Motivation: Incentives in kind, study tours, awards, certificates
4. Human resource planning (cont.)
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5. IndicatorsIndicator Definition Based-lines
20141 API/1,000 - Numerator: total of
parasite positive in the year- Denominator: Total PAR
5.45
2 Proportion of laboratory facilities with QA
HF lab participated with CNM/ total HF lab
Not Applicable
3 Proportion of health facilities reported on monthly basis
Number of HF monthly reported to CNM/total of HF
NA
4 Proportion of confirmed cases reported within 24 hours
# of confirmed cases report within 24h/ total confirmed cases
NA
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12
Health Management Information System (HMIS)
Ministry of Health
Operational Health District Office (OD)
Malaria Information System (MIS) CNM
Health Centers (HC)
Cent
ral l
evel
Perip
hera
l lev
el
Malaria Workers (VMWs/MMWs)
Private Providers (part of PPM
network)
Military/Police
Referral Hospitals (RH)
Provincial Hospital
(PH)
HMIS information flowMIS information flow
Data collection (paper forms)
Electronic data entry
Database
PHD
6. Electronic based data management
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Data Flow of MIS
National Malaria Control
Provincial Health Department
Operational District
Sender
Receiver Receiver
Operational District
Sender
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National Malaria Control
SenderReceiver
Receiver Provincial Health Department/
Operational District
Day 0 Malaria Alert System
Sender
Data Flow of Day 0 Malaria Alert System
Village Malaria Worker
Health Center
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• Revised SOP for monitoring and supervision• Check list for field trip• Set up supervision team
7. Field monitoring and supervision
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- Baseline 2015: SME system is functional to report routinely on malaria indicators related to malaria control
- Mid-term: it is expected that SME system will be revised to reflect elimination challenges in 2017-2018
- 2020: it is expected that SME will be operational in all areas eligible for malaria elimination with immediate/mandatory reporting on all confirmed cases
8. Evaluation of SME System performance
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9. Reporting
• Monthly report to higher levels • Realtime report for malaria case (SMS)• Feedback to lower level
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• The establishment of the national committee on malaria elimination has been agreed with the Minister of Health.
• The TWG and STWG have been set up to guide this process
9. Establish a National Independent Malaria Elimination Monitoring Committee
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11. Updating legislation– Malaria is notification disease
• Compulsory parasite based diagnosis (already in place);
• Private sector participation (not yet properly involved, but the private sector has to report to a public health facility on each confirmed malaria case);
• Appropriate treatment and follow up of confirmed cases (already in place); and
• Access to quality anti malarial medicines (not yet sure that all drugs are quality-assured in the private sector)
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12. Involve private sector
– Training (already in place)– Support for referral is important (already in
place for severe and complicated cases)– to ensure all suspected cases are confirmed
by RDT (yes), – notified (not yet)
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Thank you!