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Supervision framework NTP,Egypt. Prepared by Dr Nabila Wahib Supervision,coordinator.
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Supervision frameworkNTP,Egypt Prepared by Dr Nabila Wahib Supervision,coordinator
IntroductionThe NTP has set two major goals:1-reduce the suffering caused by tuberculosis among the community2-reduce the transmission of tuberculosis
In order to reach these goals, two main objectives are to be achieved. Cure rate 85 percent of the smear positive patients put on treatment detect at least 70 percent of the expected number of smear positive cases
To ensure the NTP remains focused and on track in its attempt to achieve the objectives, a model of supervision has been developed. The main objective of this supervision is to: • Support health staff to improve their performance in order to achieve the NTP objectives • a supervisor was considered a controller and not fault finder.
NTP Supervision Framework Baseline • For NTP to be able to measure progress, implementation of Programme activities need to be monitored • Supervision allows for this close monitoring, and permits for improvement of performance of health staff and timely intervention, if and where needed
Conditions for Supervision • At important conditions for effective supervision is accountability. The Minister of Health and Population holds the NTP management accountable for its achievements and failures. • Likewise, at Governorate level, the Governor, or, to be more practical, the Under-Secretary needs to hold the GCT and Chest Facility staff
And, at Chest Facility level, the Director should hold the facility staff accountable. Accepting the accountability by both parties will form the basis for commitment to reach the NTP goals and objectives (It should be clear from the outset, however, that at each level the assessment of the situation should be related to the goals and objectives of the NTP). .
A-Central Level At Central level the National Tuberculosis Control Programme under the Directorate-General of Chest Diseases develops the national policy for tuberculosis control. The target is every governorate to be visited twice per year for the big governorates and once per year for the small governoarates
This policy is based upon guidelines for TB control as provided by the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (IUATLD). These guidelines have been adapted by the NTP to suit the situation Egypt and The preparation of a Work plan for the NTP at Central level
this annual Work plan covers the following major areas: • Case Management (treatment and case-holding) • Case Detection • Drug Supply • Recording and Reporting
Training • Information Education and Communication (IEC) • Research • Intersect oral Collaboration • Programme Management
B-Governorate Level With the job description of the Governorate Coordinator for Tuberculosis (GCT) in mind the assessment of the performance and functioning of the Governorate level of the tuberculosis control Programme will be based on findings of the following areas:
1-Treatment Outcome 2-Case Detection 3-Drug Supply Management 4-Monitoring System 5-Management 6-Equipment & Supplies 7-External Relations
C-Chest Facility Level • the assessment of both facilities will largely be determined by looking into the following areas: • 1-Treatment Outcome • 2-Case Detection • 3- Drugs • 4- Laboratory
5-Recording and Reporting 6-Staffing 7-Managements 8-Equipment 9-Building 10-Patient Orientation
Planning, Implementation, Monitoring and Evaluation of supervision Plan of Supervision • Forsupervisory activities to be meaningful and effective a plan of supervision has to be prepared. This plan is subject to a number of conditions, of which the following are the most important
( political) commitment to achieving the goals and objectives relevant staff must accept accountability for implementing the Work plan relevant staff must accept the support provided through supervision
What to Supervise • With a plan of supervision available, the supervisor now needs to prepare a checklist to be used during his supervision visits This list has been adapted from a list developed by WHO.
How to Supervise: The following five-point approach, recommended by WHO, summarizes how best to obtain the information needed. • Talk with health staff • Review the patient's tuberculosis Treatment Card • Observe health staff • Talk with tuberculosis patients • Examine supplies
Problem Solving • Descripe the problem • Identify the possible causes • Identify the solussions
ACHIEVEMENTS IN SUPERVISION THE TARGET USUALLY ACHIEVED EVERY YEAR • supervisory visits to all governorates twice /year • Development of supervision guide lines • International course about supervision and quality assurance