National Strategic Plan for Tuberculosis Prevention, Care and Control 2016 – 2021
TB Free Nepal by 2050: “ Ending TB” Nepal has set an ambitious vision of ending TB in Nepal by 2050 in accordance with the National Health Policy 2014 and under the strategic direction of the worldwide initiative to end TB – the End TB Strategy. The ending of TB has been defined as less than 1 TB patient per 1,000,000 population. It is believed that a gradual expansion of the quality TB care services leading to increased access and effective implementation of the program through responsible and integrated health system will help achieve the vision.
To decrease the TB Incidence Rate by 20%, from 2015 to 2021 i.e. to identify additional 20,000 new TB cases by next 5 years. It may not only be difficult but may even be impossible to measure the part of the goal. Nevertheless, the prevalence survey to be conducted will provide a true picture on the burden of TB disease for the first time which will also be used to measure the achievement of the goal. It seems there significant changes are required in the NTP to achieve these goals. Focus will be given more on programs and activities with significant and measurable outcomes. More accountable, equitable and quality service delivery approach will be taken to make TB services universally accessible and patient centered
- To increase case notification through improved health facility-based diagnosis; increase diagnosis among children (from 6% at baseline, to 10% of total cases by 2021); examination of household contacts and expanded diagnosis among vulnerable groups within the health service, such as PLHIV (from 179 cases at baseline to over 1,100 cases in 2020/21), and those with diabetes mellitus (DM).
- To maintain the treatment success rate of 90% for all forms of TB (except drug resistant TB) by 2021
- To provide DR TB diagnose services to 50% of the presumptive MDR TB patients by 2018 and 100% by 2021 and to successfully treat at least 75% of those diagnosed.
- To expand case finding by engaging providers for TB care from the public sector (beyond MoH), medical colleges, NGO sector, and private sector through results based financing (PPM) schemes, with formal engagements (signed MoUs) to notify TB cases
- To gradually scale up Community System Strengthening Program (CSS) at 60% of the local administrative units by 2018 and to 100% of the administrative units by 2021. It will help in creating a patient friendly ambience in the health facilities, advocacy for TB patients regarding their rights which will, in turn, contribute to the diagnosis and management of TB cases
- To contribute to health system strengthening through HR management and capacity development, financial management, infrastructure, procurement and supply management in TB
- To develop comprehensive Monitoring and Evalutaion system
- To develop plans so that NTP can function even at times of crises like natural disasters or public health emergencies.
NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS PREVENTION, CARE AND CONTROL, Page No. 14