ISTC The Indonesian Experience

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ISTC The Indonesian Experience. Erlina Burhan Indonesian Society of Respirology ISTC Task Force Indonesian Medical Association. Contents. Background Initiating ISTC Endorsement Key events Roll out of ISTC Conclusions. Back ground - Present practices & need for ISTC. - PowerPoint PPT Presentation

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  • ISTCThe Indonesian ExperienceErlina BurhanIndonesian Society of RespirologyISTC Task ForceIndonesian Medical Association

  • ContentsBackgroundInitiating ISTCEndorsementKey eventsRoll out of ISTCConclusions

  • Back ground - Present practices & need for ISTCTB care is standardized & implemented in the public sector mainly through the network of Primary Health Centers and some hospitalsCXR is the commonly used diagnostic tool in hospitals & private practiceSputum smear is very much underutilized in hospitals & private practice & sputum culture is uncommonMany doctors are using other tests (serology test, PCR) instead of sputum testingTreatment regimens vary considerably in private practiceHence the need for a tool to bridge the NTP with Professional societies, Private sector & HospitalsThe Tool - ISTC

  • Process of introducing ISTCMarch 2005 : Sensitization of key opinion leader during JEMMJuly 2005: Introduction of ISTC draft to key opinion leaders (WHO/ KNCV)August 2005: Introduce ISTC to professional organization September 2005: Workshop for professional organization to develop a plan to endorse, socialize, disseminate and implement ISTCSeptember 2005: appoint ISTC team led by Indonesian Society of RespirologyOctober 2005: Various professional organization MeetingsNovember 2005: First National TB Congress with presentations on ISTC December 2005: Finalizing Work Plan for socializationSupported closely by the ATS with several visits from Dr Phil Hopewell and Ms Fran Du Melle

  • Process of EndorsementJanuary 2006: First formal Endorsement Letter from Indonesian Society of RespirologyIntroducing ISTC to the President of the Indonesian Medical Association and other Specialist Organizations (organized by Indonesian Society of Respirology)February 2006: Follow up meeting and Discussion with Indonesian Medical AssociationIndonesian Medical Association endorse the standards in February 2006

  • Launch of ISTC World TB Day 2006 : IDI (Indonesian Medical Association) formally endorsed the standards & launched by Minister of Health

  • Endorsement and Key Events ISTC Task force at IMA was established ISTC short version in Bahasa (incl addendum) Indonesia was published and disseminated ISTC is included in various scientific meetings of professional organization

  • Roll Out ISTCWith support from NTP, WHO, and KNCV; Indonesian Society of Respirology has implemented:Two days Workshops in 13 provinces in coordination with local chapters of professional societies & Provincial/District health authoritiesISTC Short version were delivered to all participants All the topics were delivered as a CD and handout to participantsIndonesian Medical AssociationDevelop National Task ForceSocialization and establishment of Provincial TF in 12 provinces to ensure sustainability & local ownershipDevelopment guideline for implementation TB in Private Practitioner Piloting TB in PP through certification and accreditation scheme

  • TOPICS Why & What of ISTC Epidemiology of TB Standard diagnosis Standard treatment Standard Public Health Responsibility MDR TB TB-HIVThe Role of Chest X RayGroup work & discussions

  • The Role of Professional OrganizationsSocialization and disseminationHaving ISTC as a topic in their annual meetings, scientific sessions and seminarsMeetings to socialize and dissemination the standards ( Hands on )ISTC articles in Journals

  • ConclusionsProfessional society members relate more easily to ISTC than NTP guidelines since it is evidence based & more clinical oriented ISTC can act as the bridge between the NTP, Professional societies & Private sectorNTPs can outsource the socialization & roll out of ISTC to Professional organizationsInvolvement of key professional opinion leaders/champions, right from introduction is important for buy in, acceptance & endorsementA Hospital assessment study done on DOTS practices in 2007/8 in Public & Private hospitals acts as baseline data to evaluate the impact of ISTC in future.