TB Control Program

Introduction:

Provincial TB Control Program Punjab is a vertical program, under administrative control of Primary & Secondary Healthcare Department and directly supervised by the Director General Health Services Punjab. The program was started in 2004 as a project and PC-1 was developed. The Program has been regularized and shifted from development to non-development mode w.e.f. July 2021. 

The estimated incidence of all types of TB cases is 259/100,000 population. The Program works to achieve the commitments made through Sustainable development Goals (SDGs) and the End TB strategy.

Diagnostic Facilities
	Microscopy	Gene Xpert	BSL-II Labs	BSL-III Labs
Total	757	168	5	3
Public	560	164	4	3
Private	197	04	1	0

Key Achievements:

1. TB case detection much improved. Even better than pre-COVID era. 

• Identification of more than 11000 TB patients through pharmacies which were previously un-notified (finding missing TB cases)
• Screening of a total of 816,148 people for TB in 2021
• Registration of 209,477 TB patients in 2021 and provision of free of cost treatment
• TB Treatment success rate maintained above 94%
• Registration of 1376 patients with Drug Resistant TB in 2021 and provision of free of cost treatment
• Drug Resistant TB Treatment success rate (TSR) maintained above 72% (Global TSR 54%).

1. First inter-sectoral coordination meeting including all vertical programs held in December to develop mechanism for integration and bi-directional patient screening.
2. Multi-Sectoral Accountability Framework implementation in Hafizabad for engagement of sectors, other than health for Tuberculosis – First time done in Pakistan
3. Establishment of specialized center in DHQ Gujranwala in 2021 for treatment of Drug Resistant TB
4. Decentralization of DR-TB Care – initiation at DHQ Khanewal & Vehari in March 2022
5. Distribution of Insaaf Medicine Cards to TB patients. 
6. Launching of e-TB mobile application for TB Case notification from pharmacies. 
7. Development of Provincial Strategic Plan 2020-23
8. PHC Strengthening workshop for Primary Health facility Doctors, Lady Health Supervisors and School Nutrition Health Supervisors
9. Introduction of Monthly Meeting with District TB Coordinators through video Link.
10. Introduction of district Score Care system to gauge district performance. 
11. Capacity Building of Program Directors DHDC and District TB Coordinators on updated National TB Guidelines
12. Capacity Building of District Statistical Officers and Data Entry Operators on DHIS-2.
13. Capacity Building of M&E Officers from districts and Private partners from all over Punjab. 
14. Training of around 3500 district health professionals (doctors / paramedics / Lab staff) on TB guidelines and Lab diagnostics 
15. Upgradation of TB Provincial Reference Labs (Lahore & Multan) for COVID-19 testing. 
16. 06 Biosafety cabinets received from WHO for COVID-19 and TB culture testing. 
17. Un-interrupted treatment of TB and DR-TB patients in COVID-19 lockdown by doorstep delivery of medicine through TTAs.  
18. Integration with Vertical Programs i.e. IRMNCH, HCP, PACP – Roadmap for developing Multi Sectoral Accountability Framework.
19. Collaboration with Pakistan Medical Association, Pakistan academy of Family Physicians etc.

Activities for 2022:

Other Activities:

• 02 days Training of Trainers on TB management at Provincial Level (TOT)-DHDC Managers
• 02 Days training of DTCs on M&E Supervisory Module
• 01 day training on DHIS and EMR
• 01 days trickle down training on EMR
• 01 Day training of SLS & DLS on M&E Supervisory Module