1. Pradip Thakali HERD Pradip Thakali HERD

2. Organization structure

3. HERD’s involvement with NTP Nepal Major Service Delivery Area: 1. PPM/ISTC/Patient Charter: 2. TB/HIV 3. ACSM 4.Practical Approach to Lung Health (PAL) 5. Research / Operational Research 6. Technical support : especially programme guideline, training material development and conduction of central level meeting of NTC

4. Working Districts of HERD (Programme – SDA Wise) SNSDAsName of the Districts 1PALKathmandu, Lalitpur, Bhaktapur, Sarlahi and Dhanusa (5 Districts) 2TBHIVKathmandu,Chitwan, Makwanpur,Parsa, Bara, Sarlahi, Dhanusa and Nuwakot (8 Districts) 3PPMKTM (KTM &Kritipur), LTP, BKT (BKT &Madhyapur), Chitwan, Parsa, Bara,Sarlahi, Dhanusa, Kavre (Banepa & Dhulikhel) (11 municipalities of 9 districts) 4ACSMKTM, LTP, BKT, Dhading, Chitwan, Makwanpur, Parsa, Bara, Rautahat, Mahottari, Sarlahi, Dhanusa, Kavre,Sindhupalchock, Dolakha, Ramechap and Nuwakot (17 Districts)

5. SNSDAsNo. of activities 1HSS/PAL13 2TB HIV32 3PPM ISTC28 4ACSM35 5 Research2 Total110 12/19/20155 NSA Phase-2 Y- 1 SDA wise Activities

6. SNSDAsName of districts 1PAL, PPM, TBHIV,ACSMKTM, Sarlahi, Dhanusa (3) 2PAL, PPM, ACSMLalitpur, Bhaktapur (2) 3PPM, TBHIV, ACSMChitwan, Parsa, Bara (3) 4TBHIV, ACSMMakwanpur, Nuwakot (2) 5 PPM, ACSMKavre (1) 6ACSMSindhupalchock, Dolakha, Ramechhap, Dhading, Rautahat, Mahottari (6) 12/19/20156 NSA Phase-2 Y 1 SDA wise Districts

7. SNName of Districts Total Number of activities 1KTM10 2Lalitpur6 3Bhaktapur7 4Chitwan6 5Makwanpur5 6Parsa6 7Bara7 8Rautahat4 9Mahottari4 12/19/20157 NSA Phase-2 Y 1 SDA wise Activities

8. SNName of DistrictsTotal Number of activities 10Sarlahi8 11Dhanusa8 12Nuwakot8 13Kavre6 14Sindhupalchock3 15Dolakha3 16Ramechap3 12/19/20158 Cont………NSA Phase-2 Y 1 SDA wise Activities

9. Around 60 DOTS centers in Kathmandu Valley Urban area

10. Key publications: training tools and guidelines

11. Key publications - IEC

12. Challenges 1.Delay in receiving NSA Phase-2 Year-1 activities 2.Inadequate activities as compared to total assigned districts. 3.Printing process of guidelines is lengthy as well as soft copies are not in place. 4.Delay in PAL logistic supply for implementation 5.Lacking supply of forms and formats to the concerned DOTS and VCT centres to run TB HIV collaborative programme (e.g. cross referral form, Register etc.) 6.Inadequate monitoring and follow up programme especially in newly initiated district. 7.Measuring PPM contribution in TB control in absence of routine recording and reporting

13. Success Story The collaboration with VCT centre of GENETUP ; to carry out intensified HIV case finding amongst TB patients. As a result of this activity, 10 (7 Male 3 Female,1.1%)) TB patients out of 883 were HIV screening positive. This result shows that there are presence of TB HIV co infection; the patients those who are under DOTS. The free screening saved TB patients time, money as well as they have been aware on their disease status.

14. Thank You