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Training for Hospital staff at East Yangon General
Hospital into DOTS to strengthen the linkage with National TB Programme
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Public Public Mix (PPM) DOTS
approach, engaging all care providers in control of TB is one of the
components of Global STOP TB strategy. Myanmar
has launched the Public Public Mix DOTS activities
as a pilot project in Four Major Public Hospitals (New Yangon
, East, West and Thingungyun
Sanpya General Hospitals) in Yangon
since May 2007. Public Public Mix initiative aims
to strengthen the TB control services, through establishing a system link
between public hospitals and public TB centers. The final outcome of the
project will result in increasing case detection, improving treatment success
and reducing drug resistance. It also provides equitable and more accessible
case management, and decreases patient's unnecessary expenses. Advocacy
meetings were conducted in four hospitals during May/June, 2007 led by Prof.
Tin Maung Cho, Prof./Head of Department, Respiratory
Medicine, Yangon
General Hospital,
Dr. Hans Kluge (Medical Officer, TB - WHO Myanmar) and National Tuberculosis Programme (NTP) officials. It was followed by the
training of 53 hospital staff on Public Public Mix
DOTS. Hospital DOTS Committee was formed for each hospital chaired by Medical
Superintendent and members from heads of clinical disciplines. The
organizational structure of the Hospital Public Public
Mix DOTS Unit was set up. Assistant Medical Superintendent was assigned as
PPM Coordinator. Roles of Laboratory, nurses, medical social workers and
pharmacist were identified. PPM DOTS in hospital has identified four options
to implement:
Option 1: Diagnosis of TB cases + prescription of
treatment regimen in hospital followed by referral to Health Center
for DOT, with clinical follow up at hospital
Option 2: Same as Option 1 without clinical follow up at
hospital
Option 3: Diagnosis of TB cases + start Directly Observed
Treatment (DOT) in hospital followed by referral to Health Center
during treatment
Option 4: Diagnosis of TB case and provide full treatment
(DOT) at hospital
Currently all hospitals are implementing option 3 and
option 4. The logistics management, recording and reporting, monitoring and
supervision systems were established for PPM DOTS.
DOTS Corner has been identified and renovated in all
hospital for counselling, health education, and DOT
activities. Teaching and education aids were supplied. NTP and WHO conducted
joint monitoring and supervisory visits regularly. Quarterly and half yearly
evaluations were conducted for the project and showing preliminary positive
outcomes in terms of increased case notification and improved patient
follow-up after discharge from the hospital.
This pilot project is supported by the 3 Diseases Fund.
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