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Integrated TB-HIV Services at PSI Clinical Social Franchise Network (Myanmar) Dr. Phyu Phyu Swe Health Services Manager (TB) Population Services International/Myanmar.

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Presentation on theme: "Integrated TB-HIV Services at PSI Clinical Social Franchise Network (Myanmar) Dr. Phyu Phyu Swe Health Services Manager (TB) Population Services International/Myanmar."— Presentation transcript:

1 Integrated TB-HIV Services at PSI Clinical Social Franchise Network (Myanmar) Dr. Phyu Phyu Swe Health Services Manager (TB) Population Services International/Myanmar 25 July 2012

2 Presentation outline TB & HIV situation in Myanmar National strategic plan for TB-HIV services integration PSI/Myanmar health service system Integration of TB-HIV service at PSI franchised network Achievement Challenges/Lessons learnt Future plan 2

3 CHINA LAOS THAILAND INDIA BANGLA DESH KACHIN SHAN SAGAING CHIN RAKHI NE MANDALAY MAGWE BAGO AYARWADDY YANGON KAYIN KAYAH MON TANINTHARYI TB & HIV Situation in Myanmar One of the 41 high TB-HIV burden countries HIV prevalence among TB patients (2010) 10.4% TB prevalence among PLHA (2010) 30-40% Global TB control, 2011, HSS 2010

4 National strategic plan for TB-HIV services integration ( ) Goal: To reduce the burden of HIV-related TB to achieve the 2015 MDG target Plan to scale up to all townships & public hospitals by 2015

5 SQH only SPH only SUN (SQH+SPH) SQH: Sun Quality Health SPH: Sun Primary Health PSI/M Health Services System Two tiered social franchise network Case management Health talk Referrer Primary care

6 Sun Quality Health Social Franchise model Franchisee Consumer Technical support Product IECs Affordable services to Health impact Healthy behavior Franchiser Fractional franchise system Monitoring & Supervision

7 RH STIs Malaria PPM-DOTS Pneumonia U5 children PICT Integrated Approach…… 2008 ART

8 Achievement of PPM-DOTS program page 8 MIS data NTP + PSI NTP only 2.3% 5.1% 7.6% 8% 11.5% 12.1%

9 RH STIs Malaria PPM-DOTS Pneumonia U5 children PICT 2008 TB-HIV Integration Referral voucher to PSI/VCT CPT ART

10 Provider Initiated HIV Counseling & Testing (2010) MIS data HIV prevalence among TB patients – 9% PICT Start voucher system

11 page 11 (1%) (8%) (11%) (21%) (26%) Achievement of TB-HIV Integrated Service MIS data 143 out of 862 SQH clinics provide PICT As of April

12 12 One Stop Service For TB-HIV 7 SQH clinics + 2 PSI/VCT 50 PLHA ART DOTS CPT PICT 862 SQH clinics 143 SQH clinics

13 Challenges  Double stigma  Time consuming  ART inavailability  Data burden  Client awareness on TB-HIV co-infection  Funding for sustainability & expansion “No ART if we found positive client” (SQHC) “We are busy we can’t afford time” (SQHC) “I dare not face the positive result” ” I don’t need the test” (Client) PSI’s qualitative research on PICT service May 2012

14 Future Plan  Expand PICT to cover 80% of TB registered cases at Sun clinics access the HCT service by 2015  Continue CPT for TB-HIV co-infected patients  Integrate ART program to PICT clinics  Strengthen ACSM activities  Strengthen referral network  Sustain collaboration with NTP, NAP and other partners

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