TB Control in PHC network and Partners Coordination in Cambodia Second Stop TB Partners’Forum New Delhi 24/03/04 Dr. Mao Tan Eang Director National Center for TB and Leprosy Control (CENAT)

I. Burden of TB in Cambodia TB is a priority disease of MoH High burden country among 22 in the world High incidence and prevalence - Incidence rate of Sm+ TB (BK+) : 242/100,000 pop. - Incidence rate of all forms : 549/100,000 pop. Death rate : 107/100,000 pop. HIV among TB patients: also high:12 % in 2003 TB cases: still in increasing trend in the coming years

II. Goals and Objectives of NTP To improve health by reducing morbidity and mortality due to TB, contributing to poverty reduction in Cambodia By 2005: - TB services at all (Minimum Package of Activities) MPA Health Centers - Case detection rate of smear + cases: 70% - Cure rate of smear + cases: > 85 % By 2015 MDG: - Reduce prevalence and death by 65-70%

III.Health System/ PHC After the reform Before the reform(1995) New Health System: 3 Levels: Central, Province,Operational District (OD) Based on population & geography : Health Coverage Plan 73 ODs Planned Facilities: - Central MoH, Centers and Institutions - 8 Nat. Hosp.(TB Center,3 TB units) - 24 Prov.Referral Hosp.(24TB units) - 45 Dist. Referral Hosp. (45TB units) - 945 Health Centers(73TB units& 706 HC with DOTS services) Before the reform(1995) 4 Levels: Central, Province, Disrict & Commune Based on administrative criteria Facilities: - Central MoH, Centers and Institutions - 8 Nat. Hosp. - 27 Prov. Hosp. - 164 Dist. Hosp. - 1267 Commune clinics

IV. Major Achievements of NTP DOTS Expansion within the PHC system(145 TB units + 706 HCs) Policies & Strategies for TB Control 2001-2005 Strategic Plan for TB Control 2001-2005 TB Multi-Drug Resistance Survey TB Prevalence Survey TB/HIV Service Inter-agency Coordination Committee for TB Control (ICC) Case detection rate : ~60 % in 2003 Cure rate : 89 %

V.Involvement of Partners/NGOs Advocacy: policy disemination Establishment and functioning of ICC About 100 NGOsIOs working for health sector After ICC, more partners coming in for TB control, now around 15 partners/NGOs

Thank You Very Much