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State:  Rajasthan   STPC : Dr Neerja Arora Biannual Review Meeting  13-18 February 2011  New Delhi CBCI CARD RNTCP Project
CHF presence in state  Institutions Total Number  Participating in RNTCP Major hospitals  9 8 Dispensaries  29 16 Social Service Bodies / Organizations under DSSC 3 DSS + 7 others 3 DSS+ 5 others 20 bedded CCCs  0 0 10 bedded CCCs  1 1
Achievements in 2010  1a Number of Trainings / Sensitizations  conducted in 12 1b Total Number of CHF personnel trained / sensitized 357 2a Number of Diocese level workshops held in 2010 1 2b Total Number of personnel sensitized  in all Diocese level workshops held in 2010 23 3 Number of State level RNTCP review meetings attended  3/4 4 Number of District level RNTCP review meetings attended  13 5 Number of  non-Catholic  health facilities involved, if any 0 6 Number of  non- Catholic  social welfare organizations involved, if any 0 7 Total Number of MoUs signed from the launch of the project till date 4
Achievements in 2010 St Francis Hospital, Ajmer Inauguration of DMC at St Francis Hospital, Ajmer Sensitisation of doctors & administrators of St Francis Hospital, Ajmer
St Francis Hospital DOT Centre Patients put on DOTS at St Francis Hospital  DOT Centre Yr 2000-2010 Trends in Treatment outcomes of ALL Categories of patients  put on DOTS at St Francis Hospital DOT Centre  ( Yr 2000 to Yr 2009  )
St Francis Hospital DMC St Francis Hospital Annexure M for 2010 Trends in  Slide positivity Rates, positivity among  Diagnoses &  Follow-ups in Year 2010 Trends in Sputum Examinations for  Diagnoses & Follow-up in Yr 2010 Month/ Year 2010 TB suspects examined TB  Suspects found positive TB Suspects undergoing repeat sputum examinations TB  Suspects found positive on repeat examination Follow-up patients examined  Patients positive in follow up Total Slides examined  Total positive slides Total negative slides Jan 11 1 0 0 19 0 60 2 58 Feb 16 0 0 0 14 2 60 4 56 Mar 18 4 0 0 17 2 70 10 60 Apr 14 3 0 0 18 2 64 8 56 May 13 5 0 0 22 1 70 11 59 Jun 22 7 0 0 15 3 74 17 57 Jul 17 6 1 0 26 3 88 17 71 Aug 23 6 0 0 51 6 148 24 124 Sep 29 7 0 0 43 1 144 15 129 Oct 34 4 0 0 53 4 174 12 162 Nov 24 3 0 0 39 6 126 18 108 Dec 26 4 0 0 36 3 124 11 113 TOTAL 247 50 1 0 353 33 1202 149 1053
Trainings & Sensitisations… Sensitisation of doctors & training of DOT Providers of CHFs in Kota district Training of DOT Providers of Kiran Domestic Workers’ Trust-12/11/10
Trainings & Sensitisations… Training of DOT Providers of JSKS, Jaipur at Bassi on 18 th  December 2010  Sensitisation at Kota Stone Marium Hospital, Ramganj Mandi  on 12 th  January 2011
Sensitisation of Diocese of Jaipur Diocese Level Sensitisation in Jaipur on 2nd December 2010   Caption: STO Rajasthan- Dr K N Gupta putting the first signatures on the pledge to fight TB  together  Caption:
GIA Payment Status to CHF S.N CHF Name , District Scheme  Signed on  dd/mm/yy Total GIA as per scheme  Amount of GIA paid  ( Rs) Amount of GIA still Pending  1 St Francis Hospital, Ajmer DMC-A 13 th  May 2010 Rs. 1.5 lacs/annum Nil Rs. 75,000/- due on 13 th  November 2010 2 Holy Family Hospital, Kota Sputum collection centre 29 th  September 2010 Rs. 60,000/- per annum Rs. 30,000/-due on 29 th  March 2011 Nil 3 Jeevan Deep CCC Sputum collection centre 29 th  September 2010 Rs. 60,000/- per annum Rs. 30,000/-due on 29 th  March 2011 Nil 4 Kiran Domestic Workers’ Welfare Society Slum Scheme 1 st  November 2010 Rs. 2,50.000/- per annum Rs. 1,25,000/- due on 1 st  May 2010 Nil
In process NGO Schemes Status  sputum  Collection Centre--2 S.N CHF ( Catholic Health Facility) Scheme  Date of  proposal submission Pending at DTO  level  Pending at STO level 1 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) ACSM 17/8/10 Y N 2 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur  Diocese) Sputum Collection Centre--1 17/10/10 Y N 3 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur  Diocese) a 17/10/10 y N 4 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) Sputum Transport centre 17/10/10 Y N 5 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) Adherence Scheme 17/10/10 y N 6 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Adherence Scheme 25/11/10 Y, DHS approval obtained on 7 th  Feb 2011, DTO on leave till 21 st  Feb 2011 N 7 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Sputum Collection  Centre--1 25/11/10 N 8 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Spuum  Collection  Centre--2 25/11/10 -do- N 9 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Sputum Transport centre 25/11/10 -do- N 10 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Slum Scheme 13/3/10 Y N
In process NGO Schemes Status  S.N CHF Scheme  Date of  proposal submission  Pending at DTO  level  Pending at STO level 11 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Adherence Scheme 13/3/10 Y N 12 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Sputum Collection-1 Centre 13/3/10 Y N 13 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Sputum Collection-2 13/3/10 Y N 14 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Sputum Transport Centre-1 13/3/10 Y N
Renewal Status as on date for schemes signed earlier than 1 Oct 2008  S.N CHF Name of Earlier Scheme Revised scheme renewed on Reasons for non Renewal 1 RCDSS Centre, Ajmer DOT Centre 1/11/2009 Continuing as independent DOT Centre 2 St Francis Hospital, Ajmer DOT Centre 1/11/2009 Continued as independent DOT Centre till 13/5/10, & then as DMC-A  cum DOT Centre
3 Major Constraints at the level of CHF with Suggested  Solutions  Major Constraints Suggested Solution 1 RNTCP nodal persons are frequently changed or unavailable 2 or more persons should be earmarked (where-ever possible) 2 There is sharp decline in motivation  &  knowledge levels when there is delay in proposal submission and/ or training  on one hand and  approval  & actual  start of service delivery on the other Maintaining contact, providing regular inputs and holding sessions for update training  3 Teething problems during implementation of Schemes, difficulties in meeting Referral targets, occasional non-DOTS/ modified DOTS  Constant contact, supervision & monitoring 4 Difficulties in keeping the field secular staff motivated as no salaries/ incentives are disbursed till the first GIA payments are received , leading to a vicious cycle as DTOs with-hold payments as sufficient outputs are not demonstrated ? First instalment should be made in the beginning
Success Story DTO Jaipur at Mother Teresa's Jaipur for patient provider meeting to combat high default rates STO & DTO’s visit to Asha Niketan Kanakheri to resolve the issue of delay  in payment of  honorarium
Asha Niketan Kanakheri- a TB-HIV hospice ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Trend in No. of TB-HIV patients  Yr 2003-2010
Jeevan-Deep CCC, Kota involved as sputum Collection cum Transport Centre
World Bank Mission ,[object Object],[object Object],[object Object],[object Object]
Community Meeting in Jaipur Jail ,[object Object],[object Object],[object Object],[object Object]
Internal Evaluation-Banswara ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Innovation- sputum transport kits ,[object Object],[object Object],[object Object],[object Object]
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Biannual Review Meeting Feb 2011

  • 1. State: Rajasthan STPC : Dr Neerja Arora Biannual Review Meeting 13-18 February 2011 New Delhi CBCI CARD RNTCP Project
  • 2. CHF presence in state Institutions Total Number Participating in RNTCP Major hospitals 9 8 Dispensaries 29 16 Social Service Bodies / Organizations under DSSC 3 DSS + 7 others 3 DSS+ 5 others 20 bedded CCCs 0 0 10 bedded CCCs 1 1
  • 3. Achievements in 2010 1a Number of Trainings / Sensitizations conducted in 12 1b Total Number of CHF personnel trained / sensitized 357 2a Number of Diocese level workshops held in 2010 1 2b Total Number of personnel sensitized in all Diocese level workshops held in 2010 23 3 Number of State level RNTCP review meetings attended 3/4 4 Number of District level RNTCP review meetings attended 13 5 Number of non-Catholic health facilities involved, if any 0 6 Number of non- Catholic social welfare organizations involved, if any 0 7 Total Number of MoUs signed from the launch of the project till date 4
  • 4. Achievements in 2010 St Francis Hospital, Ajmer Inauguration of DMC at St Francis Hospital, Ajmer Sensitisation of doctors & administrators of St Francis Hospital, Ajmer
  • 5. St Francis Hospital DOT Centre Patients put on DOTS at St Francis Hospital DOT Centre Yr 2000-2010 Trends in Treatment outcomes of ALL Categories of patients put on DOTS at St Francis Hospital DOT Centre ( Yr 2000 to Yr 2009 )
  • 6. St Francis Hospital DMC St Francis Hospital Annexure M for 2010 Trends in Slide positivity Rates, positivity among Diagnoses & Follow-ups in Year 2010 Trends in Sputum Examinations for Diagnoses & Follow-up in Yr 2010 Month/ Year 2010 TB suspects examined TB Suspects found positive TB Suspects undergoing repeat sputum examinations TB Suspects found positive on repeat examination Follow-up patients examined Patients positive in follow up Total Slides examined Total positive slides Total negative slides Jan 11 1 0 0 19 0 60 2 58 Feb 16 0 0 0 14 2 60 4 56 Mar 18 4 0 0 17 2 70 10 60 Apr 14 3 0 0 18 2 64 8 56 May 13 5 0 0 22 1 70 11 59 Jun 22 7 0 0 15 3 74 17 57 Jul 17 6 1 0 26 3 88 17 71 Aug 23 6 0 0 51 6 148 24 124 Sep 29 7 0 0 43 1 144 15 129 Oct 34 4 0 0 53 4 174 12 162 Nov 24 3 0 0 39 6 126 18 108 Dec 26 4 0 0 36 3 124 11 113 TOTAL 247 50 1 0 353 33 1202 149 1053
  • 7. Trainings & Sensitisations… Sensitisation of doctors & training of DOT Providers of CHFs in Kota district Training of DOT Providers of Kiran Domestic Workers’ Trust-12/11/10
  • 8. Trainings & Sensitisations… Training of DOT Providers of JSKS, Jaipur at Bassi on 18 th December 2010 Sensitisation at Kota Stone Marium Hospital, Ramganj Mandi on 12 th January 2011
  • 9. Sensitisation of Diocese of Jaipur Diocese Level Sensitisation in Jaipur on 2nd December 2010 Caption: STO Rajasthan- Dr K N Gupta putting the first signatures on the pledge to fight TB together Caption:
  • 10. GIA Payment Status to CHF S.N CHF Name , District Scheme Signed on dd/mm/yy Total GIA as per scheme Amount of GIA paid ( Rs) Amount of GIA still Pending 1 St Francis Hospital, Ajmer DMC-A 13 th May 2010 Rs. 1.5 lacs/annum Nil Rs. 75,000/- due on 13 th November 2010 2 Holy Family Hospital, Kota Sputum collection centre 29 th September 2010 Rs. 60,000/- per annum Rs. 30,000/-due on 29 th March 2011 Nil 3 Jeevan Deep CCC Sputum collection centre 29 th September 2010 Rs. 60,000/- per annum Rs. 30,000/-due on 29 th March 2011 Nil 4 Kiran Domestic Workers’ Welfare Society Slum Scheme 1 st November 2010 Rs. 2,50.000/- per annum Rs. 1,25,000/- due on 1 st May 2010 Nil
  • 11. In process NGO Schemes Status sputum Collection Centre--2 S.N CHF ( Catholic Health Facility) Scheme Date of proposal submission Pending at DTO level Pending at STO level 1 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) ACSM 17/8/10 Y N 2 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) Sputum Collection Centre--1 17/10/10 Y N 3 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) a 17/10/10 y N 4 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) Sputum Transport centre 17/10/10 Y N 5 Sampurna Jeevan Vikas Samiti, Banswara (Udaipur Diocese) Adherence Scheme 17/10/10 y N 6 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Adherence Scheme 25/11/10 Y, DHS approval obtained on 7 th Feb 2011, DTO on leave till 21 st Feb 2011 N 7 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Sputum Collection Centre--1 25/11/10 N 8 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Spuum Collection Centre--2 25/11/10 -do- N 9 Jeevan Dhara Samiti , Jaipur (Jaipur Diocese) Sputum Transport centre 25/11/10 -do- N 10 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Slum Scheme 13/3/10 Y N
  • 12. In process NGO Schemes Status S.N CHF Scheme Date of proposal submission Pending at DTO level Pending at STO level 11 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Adherence Scheme 13/3/10 Y N 12 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Sputum Collection-1 Centre 13/3/10 Y N 13 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Sputum Collection-2 13/3/10 Y N 14 Jeevan Dhara Samiti , Dausa (Jaipur Diocese) Sputum Transport Centre-1 13/3/10 Y N
  • 13. Renewal Status as on date for schemes signed earlier than 1 Oct 2008 S.N CHF Name of Earlier Scheme Revised scheme renewed on Reasons for non Renewal 1 RCDSS Centre, Ajmer DOT Centre 1/11/2009 Continuing as independent DOT Centre 2 St Francis Hospital, Ajmer DOT Centre 1/11/2009 Continued as independent DOT Centre till 13/5/10, & then as DMC-A cum DOT Centre
  • 14. 3 Major Constraints at the level of CHF with Suggested Solutions Major Constraints Suggested Solution 1 RNTCP nodal persons are frequently changed or unavailable 2 or more persons should be earmarked (where-ever possible) 2 There is sharp decline in motivation & knowledge levels when there is delay in proposal submission and/ or training on one hand and approval & actual start of service delivery on the other Maintaining contact, providing regular inputs and holding sessions for update training 3 Teething problems during implementation of Schemes, difficulties in meeting Referral targets, occasional non-DOTS/ modified DOTS Constant contact, supervision & monitoring 4 Difficulties in keeping the field secular staff motivated as no salaries/ incentives are disbursed till the first GIA payments are received , leading to a vicious cycle as DTOs with-hold payments as sufficient outputs are not demonstrated ? First instalment should be made in the beginning
  • 15. Success Story DTO Jaipur at Mother Teresa's Jaipur for patient provider meeting to combat high default rates STO & DTO’s visit to Asha Niketan Kanakheri to resolve the issue of delay in payment of honorarium
  • 16.
  • 17. Jeevan-Deep CCC, Kota involved as sputum Collection cum Transport Centre
  • 18.
  • 19.
  • 20.
  • 21.