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SR Coordination Meeting
Marie Adelaide Leprosy Centre
23rd,July,2016 Islamabad
Global Fund – New Funding
Model (NFM)
Implementation of Public
Private Mix InterventionsProject Duration: July,2015-Dec,2017
NFM-GOALS AND OBJECTIVE
Goals:
The New Funding Model (NFM) grant will contribute to achieve the goal of the national strategy to control TB in Pakistan, which is to reduce by 50% the prevalence of TB by 2025 in comparison to 2011.
Objective:
To increase the number of notified TB cases from 298,981 in 2013 to at least 420,000 by 2020 while maintaining the treatment success rate at 91%.
NFM OVERVIEW
New Funding
Model (NFM)
Start date Jul 01, 2015
End date December 31, 2017
Program
Coverage
Punjab: 27 Districts
Sindh: 16 Districts
KP: 15 Districts
Balochistan: 09 Districts
AJK: 04 Districts
GB: 03 Districts
And Islamabad
Implementing
Partners (Sub-
Recipients)
ACD, ASD, BCF, PLYC, SPO,
MALC and MC-PIU
S. No. Name of DistrictsNew/
Existing
1 Bagh Existing
2 Kotli New
3 Mirpur Existing
4 Bhimber Existing
5 Diamer Existing
6 Gilgit Existing
7 Skardu Existing
8 Chitral Existing
MALC Districts
Activities Targets
Number of notified cases of all forms of TB -
bacteriologically confirmed plus clinically diagnosed, new
and relapses
2,241
Number of notified cases of bacteriologically confirmed TB,
new and relapses1,125
Percentage of bacteriologically confirmed TB cases
successfully treated (cured plus completed treatment)
among the bacteriologically confirmed TB cases registered
during a specified period
671
Proposed Targets for MALC
Activities Targets
Number of Doctors from private health facilities received
Basic training on TB DOTS as per National Guidelines128
Number of Doctors from private health facilities received
Refresher training on TB DOTS as per National
Guidelines
221
Number of Paramedics from private health facilities
received Basic training on TB DOTS as per National
Guidelines
128
Number of Paramedics from private health facilities
received Refresher training on TB DOTS as per National
Guidelines
221
Proposed Targets for MALC
Activities Targets
Number of Lab Technicians from private health facilities
received Basic training on TB DOTS as per National
Guidelines
21
Number of Lab Technicians from private health facilities
received Refresher training on TB DOTS as per National
Guidelines
29
Number of chest camps conducted 79
Number of community events conducted 79
Number of meetings with area notables held 79
Proposed Targets for MALC
NFM OVERVIEW-MAJOR ACTIVITIES
• Training for GPs, Paramedics, Lab technicians
• Community Events(Community Gathering, Meeting with notables,
Chest Camps)
• Community Awareness
• Recording and Reporting
• Monitoring and Evaluation
• Coordination with PTP and District Health Officials.
P1 P2 P3 P4
DistrictTarget
(Jul-Sep)
Total Achieved in 3rd Quarter
Target (Oct-Dec)
Total Achieved in 4th Quarter
Target (Jan-Mar)
Total Achieved in
Jan
Total Achieved in
Feb
Total Achieved in Mar
Target (Apr-Jun)
Total Achieved in Apr
Total Achieved in May
Total Achieved in June
Total Targets till
Feb Cumulative
Targets Achieved
Till Jan Cumulative
%
Bagh 14 25 14 27 14 14 12 14 15 12 21 16 57 141 247%
Kotli 49 0 49 1 49 1 5 5 50 7 11 17 197 47 24%
Mirpur 25 10 25 36 25 7 23 12 26 12 15 15 101 130 129%
Bhimber 28 8 28 34 28 1 16 18 29 13 17 10 113 117 104%
Diamer 15 2 15 12 15 3 26 41 15 7 7 5 60 103 172%
Gilgit 8 6 8 10 8 7 4 6 7 5 9 6 31 53 171%
Skardu 18 6 18 19 18 4 12 17 18 8 11 6 72 83 115%
Chitral 15 0 15 6 15 4 4 9 13 6 13 7 58 49 84%
Total 172 57 172 145 172 41 102 122 173 70 104 82 689 723 105%
Comparison B/w Targets And Achievements
DistrictTarget(Jul
-Sep)
Total cases
achievedin 1st
Quarter
%Target (Oct-Dec)
Total casesachieved
in 2nd Quarter
%Target (Jan-Mar)
Total cases
achievedIn 3rd
Quarter 2016
%Target (Apr-Jun)
Total cases
achievedin 4th
Quarter 2016
%
Bagh 14 25 179% 14 27 193% 14 40 286% 15 49 327%
Kotli 49 0 0% 49 1 2% 49 11 22% 50 35 70%
Mirpur 25 10 40% 25 36 144% 25 42 168% 26 42 162%
Bhimber 28 8 29% 28 34 121% 28 35 125% 29 40 138%
Diamer 15 2 13% 15 12 80% 15 70 467% 15 19 127%
Gilgit 8 6 75% 8 10 125% 8 17 213% 7 20 286%
Skardu 18 6 33% 18 19 106% 18 33 183% 18 25 139%
Chitral 15 0 0% 15 6 40% 15 17 113% 13 26 200%
Total 172 57 33% 172 145 84% 172 265 154% 173 256 148%
Targets & Achievements – All Cases (For P1,P2,P3 and P4)
Cases Detected in 1st Quarter 2015
25
0
10
8
2
6 6
00
5
10
15
20
25
30
Bagh Kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
1st Quarter
1st Quarter
Cases Detected in 2nd Quarter 2015
27
1
3634
1210
19
6
0
5
10
15
20
25
30
35
40
Bagh Kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
2nd Quarter
2nd Quarter
40
11
42
35
70
17
33
17
0
10
20
30
40
50
60
70
80
Bagh Kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
3rd Quarter
P1 2016
Cases Detected in 3rd Quarter 2016
Cases Detected in 4th Quarter 2016
49
35
42 40
19 2025 26
0
10
20
30
40
50
60
Bagh Kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
4th Quarter
P2 2016
0
10
20
30
40
50
60
70
80
Bagh Kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
Comparison of P1, P2, P3 and P4
P1 P2 P3 P4
Breakup of cases detected during P2
2015
84
15 5
0
13
4
1628
1
2 1
1
23
10
3
2
4
74
0
0
5
27
34
6
14
10
1
36
19
0
10
20
30
40
50
60
70
80
Bagh Bhimber Chitral Diamer Gilgit Kotli Mirpur Skardu
Total cases
Extra pulmonary
pulmonary/Clinically diagnosed
Bacteriologically +ve
Breakup of cases detected during P3
2016
40
11
42 35
70
1733
17
26
9
2626
0
2
15
0
11
0
12
73
7
14
12
3
2
4
2
67
8
4
5
0
20
40
60
80
100
120
140
160
bagh kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
Total Pulmonary/Clinically Diagnosed B+ve Extra Pulmonary
4935 42 40
19 20 25 26
41
33 23 31
0 0
9 3
7
115 9
5 7
1415
1
1
4 0
14 13
2 8
0
20
40
60
80
100
120
bagh kotli Mirpur Bhimber Diamer Gilgit Skardu Chitral
Total Pulmonary/Clinically Diagnosed B+ve Extra Pulmonary
Breakup of cases detected during
2016
S.no DistrictsTotal Targets till
Mar (Cumulative)Total Achievements till March
(Cumulative)No. of B+ve Cases
(Cumulative)%
1 Bagh 42 92 26 62%
2 Kotli 147 12 0 0%
3 Mirpur 75 88 24 32%
4 Bhimber 84 77 14 17%
5 Diamer 45 84 8 18%
6 Gilgit 24 33 16 67%
7 Skardu 54 58 20 37%
8 Chitral 45 23 13 29%
Total 516 467 121 23%
% Of B+ve Cases against the Target (Cumulative)
S.No. District Reasons for under
performance
Activities Timeline Responsible Update
1 Bagh 02 labs yet to start working
Provision of microscopes/nonconsumable items (interim arrangement by SR)
First week of April
NTP /PRRC & PM
2 Bhimber O1 lab yet to start working
Provision of microscopes/nonconsumable items (interim arrangement by SR)
First week of April
NTP/PRRC & PM
3 Chitral 02 labs yet to start working
Provision of microscopes/nonconsumable items (interim arrangement by SR)
First week of April
NTP /PRRC & PM
4 Kotli 03 labs yet to start working
Provision of microscopes/nonconsumable items (interim arrangement by SR)
First week of April
NTP /PMRC & PM
5 Mirpur All GPs are not reporting
Increase number of monitoring visits to non-reporting GPs
Revised monitoring plan from April
RC
6. Gilgit All GPs are not reporting
Increase number of monitoring visits to non-reporting GPs
Immediate/P4
RC
7. Diamer All GPs are not reporting
Increase number of monitoring visits to non-reporting GPs
Immediate/P4
RC
8. Skardu O1 lab yet to start working
Provision of microscopes/nonconsumable itemsIncrease number of monitoring visits
Immediate/P4
NTP/PMRC & PMs
Way Forward
Current Practices Improved Strategy
General Monitoring More specific task oriented monitoring of DFS, meeting with GPs, visiting labs and Patients follow up for better compliance and ensure contact tracing
Generic reporting Quality report with issues identified and solution suggested with follow up
Less number of visits by Project manager More frequent visits to the targeted districts with clear objectives
Quality Monitoring
IndicatorTarget for
P1Achieved %
Target For P2
Achieved %Target For
P3Achieved %
Doctors Training 49 0 0% 48 8 17% 58 72 124%
Paramedics Training 49 0 0% 48 8 17% 58 88 152%
Refresher Training 0 0 0% 0 0 % 71 0 0%
Lab Tech Training 9 0 0% 4 0 0% 8 6 75%
Chest Camp 7 0 0% 8 6 75% 8 20 250%
Community Event 7 0 0% 8 6 75% 8 22 275%
Meeting with Notable
7 0 0% 8 6 75% 8 20 250%
Targets & Achievements - Trainings & Activities for P1,P2 & P3
Districts Total Targetstill P3
Achieved Targets
% Backlog
Bagh 42 92 219% NilKotli 147 12 8% 135
Mirpur 75 88 117% NilBhimber 84 77 92% 7Diamer 45 84 186% NilGilgit 24 33 137% Nil
Skardu 54 58 107% NilChitral 45 23 51% 22
516 467 91%
Target/Achievement till P3 & Backlog
Challenges to address:
• Timely submission of supporting documents (Readable, duly verified)
• Detection of new cases
• Contact Screening
• Active case finding in hyper endemic areas
• Efforts to increase B+ve cases
• Training of required Human Resource
Thank you
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