TB CARE I - Kyrgyzstan Year 3 Quarterly Report April - June 2013

In Universal and Early Access, the implementation progress on collaboration work between prison and general healthcare systems was reported, with gaps identified, action plans corrected, and next steps determined during a joint collaboration plan meeting conducted in June. The first Coordination Council meeting was held to discuss the findings from the complex assessment of the Chui Oblast TB Service, conducted by the Ministry of Health in June. In Laboratories, an international specialist on laboratory maintenance, Franco Ramoso, conducted a visit to review the situation on the maintenance of lab equipment, present his findings, and discuss the final version of the maintenance guidelines to the laboratory Technical Working Group. The Regional TB CARE I IC Officer conducted monitoring visits and risk assessments in seven oblast TB centers, providing on-the-job updating training for previously trained IC-responsible specialists with newly delivered TB IC equipment. TB CARE I PMDT consultant improved PMDT practices by conducting four trainings on MDR TB for doctors from TB and prison services, the Health Insurance Fund, and the HIV/AIDS and SES services, and two trainings for nurses from the TB service. The regulations on palliative care for TB patients were approved by the Ministry of Health in May, and the annex to the guidelines on palliative care for TB patients and instructions on palliative care for caregivers of TB patients were finalized by an international expert and local NTP specialists. In M&E, the heads of the oblast TB centers, SES specialists, and M&E specialists improved practices and updated knowledge during the training "Quality Data Management and Data Analysis" for decision makers and M&E specialists conducted in June. Four members of the KG TWG on the development of the National M&E Plan trained on the regional M&E training in Almaty in April, and the Regional M&E TO provided support to the TWG on the development of the National M&E Plan. TB CARE I remained on target with most activities, but the extension of the TB REACH project resulted in the postponement of relocation of machines and trainings on Xpert implementation in new sites until the next quarter. The lack of staff continues to affect the pace of implementation, with the departure of PMDT specialist Tatyana Toichkina in June and the joining of the Kyrgyzstan team by Oleg Sheyanenko in June, who will focus on TB IC. The joint plan for TB control in prisons and general TB services was approved by the Ministry of Health and the Prison Service in January, and a joint meeting for monitoring, correcting, and implementing the joint collaboration plan was conducted in June. The regulations on Coordination Council meetings were updated and approved by the Ministry of Health, and the first Coordination Council meeting was held in June to discuss the findings from the complex assessment of the Chui Oblast TB Service. The training on outpatient care and psychosocial support for TB patients was conducted in March, and regular trainings for medical specialists from pilot facilities FMC #9 and #14 were conducted. The curriculum was updated in accordance with the outpatient guidelines, and patient satisfaction forms and psychosocial support forms were customized to fit the KG situation. The draft protocol for outpatient care was finalized in March and reviewed by the KNCV Regional Office. The time frame for Xpert training depends on the relocation of Xpert machines, which is subject to NTP decision-making and TB REACH/QHCP. The TB REACH project was extended until the end of June, resulting in the postponement of relocation of the machines. Supportive supervision visits to monitor Xpert implementation are tentatively scheduled to take place after June 2013.