FY2015 Annual Performance Report: Control and Prevention of Tuberculosis in Thailand

The focus of CAP-TB Thailand has been on health system and provider-level interventions. At the health system level, the project aimed to strengthen coordination between health care facilities at different levels, a critical element to maximize the TB network's capacity for providing continuity of care. The project worked in close collaboration with the key implementing agencies, Rayong Provincial Health Office (PHO) in Rayong and Makarak Hospital in Kanchanaburi to strengthen communication and coordination among health care providers and partners within the TB network. At the provider level, the project focused on building technical capacity of health care providers, village health volunteers (VHVs) and partners through teaching sessions using complicated patient cases to introduce the teaching topics, training sessions for VHVs in Ta Pong and Yai Da subdistricts, Rayong Province and training on provider-patient communication (Motiv8) for health care providers in Rayong. In addition to these activities, the project also supported five coordinators, three in Rayong and two in Kanchanaburi, and built their capacity to assist the TB network in their province to provide proper care and support to MDR-TB patients. These five coordinators play a vital role in keeping the patient cohort information up-to-date for discussions at case conferences and supporting TB networks in patient care and management. In FY15, the project supported Rayong partners to pilot a model for comprehensive Programmatic Management of Drug-resistant (PMDT) in Ta Pong and Yai Da subdistricts. The model aims to mobilize the community to assist health care providers in providing care and support to MDR-TB patients. VHVs in Ta Pong and Yai Da subdistricts were recruited and equipped with TB/MDR-TB knowledge and skills to enable them to support the work of health care providers in screening for presumptive TB patients and providing DOT for MDR-TB patients. Five committees and working groups were formed in these subdistricts to support the implementation of the Ta Pong Model. Ta Pong Subdistrict Administration Organisation (SAO) also committed their support for transportation and treatment cost for TB/MDR-TB patients who are in need, a strong indication of political commitment. In addition to activities implemented through coordination with project partners in Kanchanaburi and Rayong Province, the project also worked with the Bureau of Tuberculosis (BTB) at the national level to support the decentralization of MDR-TB expertise to regions throughout Thailand. The project supported the introduction and utilization of an online support desk as a platform for physicians and health care providers countrywide to seek consultation from the BTB's drug-resistant tuberculosis (DR TB) experts. The project also supported the Medical Service Department of Bangkok Metropolitan Administration (BMA) in organizing a case conference for physicians, nurses, and interested personnel from BMA hospitals and departments in Bangkok. A total of 1,859 persons received knowledge on TB prevention and treatment from activities organized to commemorate World TB Day in the project catchment areas in Rayong Province. Of these, 1,227 persons received TB knowledge through small group activities. Rayong Provincial Health Office (PHO) in collaboration with the six primary hospitals and Foundation for AIDS Rights (FAR) organized campaign activities to raise awareness among the public about TB, MDR-TB and HIV infection. The activities were organized in four areas namely Klaeng District, Ta Pong Subdistrict, Ban Khai, and Mabtapud Subdistrict. The project also introduced The Practical Guide: Tuberculosis Infection Control in Public Health Units, Congregate Settings, Communities and Households in Rayong (TB IC guide) and corresponding checklists. This was introduced to representatives from provincial and community hospitals in Rayong on 19 November 2014. A total of 21 participants attended the meeting, with representation from Rayong PHO, registered nurses and public health officers from public hospitals, including Mongkut Rayong Hospital and Rayong Central Prison.