Miss farida's presentation

PUBLIC-PRIVATE PARTNERSHIP IN HEALTH

CARE

Farida Rajput3rd Year Student

School of NursingJPMC, Karachi

Tuberculosis is Curable

Public private partnership

Public-Private Partnership (PPP) describes a government service or private business venture which is funded and operated through a partnership of government and one or more Private Sector companies

When these partnership works in community to promote health is known as “Public-private partnership in health care”

INTRODUCTION

What is Tuberculosis ?• Tuberculosis (TB) is a contagious, air-borne disease

caused by a mycobacterial infection.• It primarily affects the lungs but can also affect any

other part of the body.• It is spread through the air when someone with

active TB disease coughs, sneezes, etc.• TB is a curable disease, with effective, low-cost

treatment available worldwide.

Types of Tuberculosis• Pott’s disease — TB of the spine with destruction of

vertebrae resulting in curvature of the spine• Miliary Tuberculosis — acute tuberculosis characterized

by the appearance of tiny tubercles on one or more organs of the body (presumably resulting from tubercle bacilli being spread in the bloodstream)

• Pulmonary tuberculosis, consumption, phthisis, phthisis, wasting disease, white plague — involving the lungs with progressive wasting of the body

• Scrofula, stuma, king’s evil — a form of tuberculosis characterized by swellings of the lymphatic glands

• Lupus vulgaris — tuberculosis of the skin; appears first on the face and heals slowly leaving deep scars

Medical History

• Known exposure to a person with infectious pulmonary TB

• Symptoms of TB disease and approximate late symptoms started

• Previous treatment for latent TB infection or active TB disease

• Other medical conditions that might affect treatment approach

TB Kills in PakistanThe country ranks sixth on the World Health Organization's (WHO) list of high-disease burden countries and accounts for 44 percent of all TB cases in the WHO's Eastern Mediterranean region. The 2003 World Health Report of the WHO records that the annual incidence of TB cases in Pakistan is a whooping 171 per 100,000 persons. Each year, at least 268,000 new cases are added to the existing patient population of around 1.8 million. Every year TB kills 64,000 people in the country causing 26 percent of the deaths that could be avoided through treatment. Most patients fall in the productive age ranging between 15 and 45, with half of the percentage being women.

Case Finding

• Drug Rehab Centers• HIV Care facilities• Private medical clinics• Occupational Health

facilities• Long term care facilities

and shelters

• TB Chest Clinics• Hospitals (Public)• Public Health Clinics• Voluntary Counseling and

Testing (VCT) clinics• Prevention of Mother to

Child Transmission (PMTCT) clinics

• Correctional facilities (prisons, jails)

Opportunities for Case Finding

Steps in Diagnosing TB

Medical HistoryBacteriologic

examinationDrug Susceptibility

TestingRadiographic examOther examinations

based on site(s)/location(s) involved

Extrapulmonary Tuberculosis

Typical Systemic Symptoms

• Fever in 65-80% of cases• Night sweats• Fatigue/malaise• Anorexia/weight loss 10-20% of TB cases have no symptoms at

the time of diagnosisTB can be related to cough, fever, and weight

loss.If untreated, fatal in over 50% of cases.

Medical Treatment• Following are the main medical treatment for

T.B.• Tab. Refampacin.• Tab. Ethambutal.• Tab. Pyrazenamid.• Tab. INH.• Tab. Pyridoxine.• Inj. Streptomycine.• Myreine P-Forte (including all compositions). • All these treatment given to patient according to

advice.

Nursing Management

• Reassure the patient or patient’s family.• Provide hygienic care.• Check and record vital signs.• Given treatment as per prescription.• Advice for proper diet.• Advice for proper follow-up.

Community Participation

• Arrange health program or awareness of T.B in community.

• Provide proper health education to people how to prevent the diseases.

• Educate about proper hygienic care.• Educate about how to take medicine.• C.H.N should survey to community and record

any case.

Concerns

• Drug-resistant strains of TB are developing over time.

• Risk of TB in people with weakened immune systems, such as AIDS patients.

• Absence of national TB programs in undeveloped countries.

Conclusion • TB has been in existence since ancient times• Different treatments were used long ago.

– Some successful, some not• TB is still a great concern to this day.• Transmission a great concern.• Current treatments available that are

sufficient, but for how long?• Countries worldwide need to take part in the

prevention of future TB outbreaks

The Global Plan to Stop TB

2009-2015- Achieve the Millennium Development Goal to have halted and begun to reverse the incidence of TB by 2015- Save an additional 14 million lives

- Treat 50 million people for TB

- Expand access to high-quality TB diagnosis and treatment for all

- Put 3 million TB patients co-infected with HIV on ARVs

-Treat 800,000 people for MDR-TB – [to be adjusted for XDR]

- Produce the first new anti-TB drug in 40 years by 2010

- Develop a new vaccine by 2015

- Provide rapid and inexpensive diagnostic tests at the point of care

USAID Health Organization

USAID The U.S. Agency for International Development (USAID), in

close collaboration with global, regional, and developing country partners, is committed to addressing the global burden of tuberculosis (TB), which kills about 1.7 million people annually. Over the past six years the United States has helped provide effective treatment for 10 million people with TB in 78 countries. The U.S. Government, through USAID, is the leading bilateral donor in the world for TB and supports the expansion and strengthening of TB control in 37 countries. Between 2000 and 2006, USAID provided about $500 million to support TB programs worldwide.

Partnerships

USAID partners in TB control in the Dominican Republic include the NTCP, the Pan American Health Organization, the TB Coalition for Technical Assistance Project (TBCTA Project), and Management Sciences for Health’s Rational Pharmaceutical Management plus program.

Controlling the Spread of Tuberculosis

• Pakistan has the eighth-highest incidence of tuberculosis (TB) in the world.

• Since 2004, USAID's Strengthening Tuberculosis Control program has contributed nearly $6 million to the National TB Control program in Pakistan.

• USAID has provided training to the technical staff who deliver diagnostic services and treatment.

• All government health centers have now adopted the DOTS program. USAID is helping to expand this internationally-approved treatment regimen to the private sector, thus greatly improving identification and treatment throughout the country. Detection of TB cases has tripled since 2003, and the treatment success rate has shown solid improvement

USAID assistance includes support for

Strengthening the TB monitoring and evaluation system Training health personnel, including doctors, nurses,

laboratorytechnicians, and health promoters, in the DOTS approach Improving laboratory infrastructure, capacity, and quality

control Enhancing the technical, planning, management, and

supervisory capacity of the NTCP Strengthening TB drug management Developing educational materials and community education

and social mobilization strategies .

Thank you !

Where to go for more information on Tuberculosis

WWW.USAID.COM