11-14 Nov 5111-14 Nov 51 11

Stop TBStop TBChallenging for Effective ManagerChallenging for Effective Manager

นพนพ. . ศุ�ภกิ�จ ศุ�ริ�ลั�กิษณ์� พบศุ�ภกิ�จ ศุ�ริ�ลั�กิษณ์� พบ., ., อวอว., ., MPHM.MPHM.

ผู้��อ��นวยกิ�ริสำ��น�กินโยบ�ยแลัะผู้��อ��นวยกิ�ริสำ��น�กินโยบ�ยแลัะย�ทธศุ�สำตริ�ย�ทธศุ�สำตริ�

11-14 Nov 5111-14 Nov 51 22

6 Policy Implementation Projects :6 Policy Implementation Projects :

TBTB

Breast FeedingBreast Feeding

Refer CenterRefer Center

Food SafetyFood Safety

NCD ( Lifestyle Disease)NCD ( Lifestyle Disease)

Public Health Emergency ResponsePublic Health Emergency Response

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TB Situation :TB Situation :

1.1. World Rank 18/22 World Rank 18/22

Detection Rate ≥ 70Detection Rate ≥ 70 % %

Success Rate of Success Rate of DOTS ≥ 85 DOTS ≥ 85 %%

World Health Organization report ,

2008

Progress in high-burden countries, 2005-2006Progress in high-burden countries, 2005-2006

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TB Situation :TB Situation :

2. Thailand (2007)2. Thailand (2007)

Detection Rate Detection Rate ~ ~ 7070 % %

Success RateSuccess Rate– 66 Provinces 66 Provinces < < 85%85%– 16 Provinces ≥ 85%16 Provinces ≥ 85%– 4 Provinces ≥ 90%4 Provinces ≥ 90%

– The Lower Top 3The Lower Top 3NakornsrithammaratNakornsrithammarat 30%30%ChonburiChonburi 40%40%RanongRanong 51%51%

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TB Situation :TB Situation :

2. Thailand (2007) Cont.2. Thailand (2007) Cont.

MDR (2006)MDR (2006)– New casesNew cases 1.6 %1.6 %– Old casesOld cases 34 %34 %

XDRXDR– 13 cases13 cases (Siriraj)(Siriraj)– ? cases? cases (Border)(Border)

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TARGET :TARGET :

For Every ProvinceFor Every Province

Detection Rate ≥ 70 %Detection Rate ≥ 70 %

Success Rate ≥ 85 %Success Rate ≥ 85 %

Province Champion ( Province Champion ( > > 40 provinces)40 provinces)

Success Rate ≥ 90 %Success Rate ≥ 90 %

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Case Detection :Case Detection :

Passive DetectionPassive Detection : Conventional : Conventional ProcessProcess

Specific DetectionSpecific Detection : HIV : HIV ve, DM, etc.ve, DM, etc.

Active FindingActive Finding : Risk Areas (Selected): Risk Areas (Selected)

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DOTS Strategies :DOTS Strategies :Political commitment with increase sustained Political commitment with increase sustained financingfinancing

Case detection through quality-assured Case detection through quality-assured bacteriologybacteriology

Standardized treatment with supervision and Standardized treatment with supervision and patient supportpatient support

Effective drug supply and management Effective drug supply and management systemsystem

Monitoring and evaluation system and impact Monitoring and evaluation system and impact measurementmeasurement

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Mechanism :Mechanism :Ms. / Mr. TBMs. / Mr. TB– PHOPHO– HospitalHospital

PTC / DTCPTC / DTC

HTCHTC

TB ClinicTB Clinic

Health Volunteer, TB workerHealth Volunteer, TB worker

PartnersPartners

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M & E :M & E :

Systemic Report (SMART TB?)Systemic Report (SMART TB?)

Regular MeetingRegular Meeting

SupervisionSupervision

COHORT Analysis & ReportCOHORT Analysis & Report

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Outcome Definition :Outcome Definition :

Detection RateDetection Rate

Conversion RateConversion Rate

Complete RateComplete Rate

Cure RateCure Rate

Success RateSuccess Rate

Default RateDefault Rate

11-14 Nov 5111-14 Nov 51 1414

The Country EndThe Country Endbut Your Meanbut Your Mean