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Scaling Up Joint TB/HIV Activities

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Presentation on theme: "Scaling Up Joint TB/HIV Activities"— Presentation transcript:

1 Scaling Up Joint TB/HIV Activities
Situation analysis/Baseline review Roleplayers/stakeholders Existing initiatives Current human resources and workload Level of performance of core activities Consensus on indicators, targets, recording and reporting forms required before expansion

2 Define Core Activities
District public/private/NGO TB/HIV collaboration DOTS & syndromic STI managment VCT ACF IPT, CPT, Ois Community mobilisation - DOT, HBC in continuum of care PMTCT, ARVs

3 Prerequisites for Scaling Up
Evidence-based advocacy Political commitment (financial and human resources, strategic planning, donor buy-in) Coordinating committees at all levels - robust district management structures Strengthen managerial skills in coordinators Strategic and operational planning Share best practices

4 Financial Resources - Extra Cost Items
Health system support - coordination Drugs - isoniazid, cotrimoxazole, drugs for Ois, TB, STI, PMTCT, ARVs Nutritional support Diagnostics - sputum containers, microscopes, rapid HIV tests Transport and logistics

5 Extra Cost Items Capacity Building
in-service training Human Resources (salaries, incentives) doctors, nurses, counsellors, community volunteers/workers including PWAs for DOT & HBC, PWA support

6 How to Ensure Adequate Human Resources
Optimal staffing levels not known - to be determined locally 1 nurse can see about 40 patients/day 1 counsellor can counsel 6-10 clients/day 1 counsellor mentor can mentor 20 counsellors

7 Staffing Levels At district level, audit existing # of each category of staff Estimate number of staff required based on targets Measure staff attrition due to illness, migration or promotion Mobilise additional HR through creating/filling posts, incentives, compulsory community service

8 Steps for Ensuring Adequate Sources of New Staff
Coordinate with Ministry of Health and academic institutions Consider authorising lower level staff to perform different activities Make decisions about what activities can be performed by each cadre (eg screening, rapid testing) Mobilise existing human resources Volunteers vs paid community workers

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