Quarterly Report: April - June 2011

The program's overall work plan completion stands at 14%, with technical and administrative challenges being addressed. One of the notable achievements is the implementation of the "Photovoices" strategy, which utilizes photography as a tool for participatory research to engage people affected by TB and mobilize decision-makers. Ten individuals actively involved in the project have taken photographs representing their experiences, feelings, and realities related to tuberculosis. The program has also made progress in expanding the ACSM model, piloted in Health Area IV of Santo Domingo, to other areas. This expansion is based on the ACSM expansion plan, with a focus on consolidating the model in Area IV, expanding to Area V, and extending to Area VIII and the Urban Area of Elias Pina province. The program has also initiated activities in close collaboration with the TB coordinators to sustain these PPM/ACSM activities. In the area of infection control, the program has trained 100 persons in IC in all health facilities, with a focus on implementing infection control plans in health units according to internationally implemented standards. Four health centers have developed their plans, and the hospital's IC team is starting to implement their workplan, including organizational service changes and remodeling. The program has also made progress in prevention and case management according to international standards, with a meeting held with the National MDR coordinator and NTP manager to update the National MDR case management guidelines. The program has also initiated activities to increase access to timely diagnostics of MDR TB, with a local USAID mission requested to purchase Gene Expert machines. In addition, the program has reactivated the Stop TB Committee in Area VIII and started forming Stop TB committees according to plan and consolidating the existing ones. The program has also made progress in improving TB timely diagnostics and notification by private health services, focusing on zona franca factories, independent medical cabinets, and private clinics. The program has also strengthened the quality of TB information systems at all regional and provincial levels, with three provinces visited to collect data and on-the-spot training of data collection and interpretation of data for management. All Health Areas and Provinces (100%) will be visited for this purpose. The program has also provided feedback with relevant TB epidemiologic information to all regional and provincial levels, with a semestral statistical bulletin elaborated and distributed to provinces. The program has also enhanced and facilitated the information access of TB to all interested public, with a TB web page created and updated. However, this activity was canceled due to unforeseen circumstances. The program has also made progress in reducing delays in the diagnosis of TB, with a focus on expanding the community involvement model as successfully piloted in Area IV under TBCAP to other project areas.