Transport system

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E G Y P T
PPPMin Egypt
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Introduction

• Tuberculosis is a major public health problem in
  Egypt.
• It is estimated that approximately 19,000 new
  cases of TB develop in Egypt annually, of which
  an estimated 9,500 are suffering from the
  infectious smear-positive pulmonary form.
• In 2003, NTP detected 5,118 SS cases
  representing about 55 of the expected cases.

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Introduction (cont.)

• From the beginning, the NTP recognised that
  the involvement of different providers of health
  care would be essential to the success of TB
  control.
• Since then the NTP has established links with
  a variety of public and private providers of
  health care.
• These institutions have played a considerable
  part in the achievements of the programme to
  date.
• However, if case detection rate is to
  improve, these links will have to be strengthened
  considerably

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Non Governmental Organizations (NGOs)

• NGOs play a key role in TB control.
• They have a strong community-oriented approach.
• This approach can be used to increase community
  awareness and encourage TB patients to access
  health services.
• The NTP provides training and orientation on TB
  for NGOs staff about health education to TB
  patients

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The private sector

• Egypt has a significant private health care
  sector with over 50 of all utilization and
  expenditure on health care occurring in the
  private sector.
• One of the main explanations for low case
  detection is that, although MOHP services are of
  high quality, significant portions of the
  population prefer the private sector.

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The private sector (cont.)

• There have been several studies into the private
  sector TB treatment in Egypt.
• These suggestions suggest there is a huge
  potential to identify TB cases in the private
  sector and improve diagnostic and treatment
  practices.
• Yet, the best mode of collaboration is not
  clear.

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The private sector (cont.)

• There are several key issues that need to be
  addressed
• Should the private sector be supported to refer
  cases, diagnose them, or treat them or all three?
• If the private sector is supported in treating
  TB, how to ensure the private sector has access
  to the correct drug regimens and prescribes them
  in the correct way?
• What type of payment or incentive system is
  required to ensure the notification, correct
  diagnosis and treatment of TB patients?
• What is the best way to monitor both the
  effectiveness and quality of private sector TB
  services?
• How to best involve pharmaceutical companies,
  private pharmacies and laboratories?

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Health Insurance Organization (HIO)

• The NTP began collaboration with the HIO in 1997
• In 2001 the HIO agreed that HIO patients would be
  diagnosed and treated in specialist TB clinics.
• The HIO has established 52 specialist TB clinics
  in Egypt.
• Each center is responsible for the diagnosis,
  follow-up and treatment and registration of TB
  cases according the NTP guidelines.
• Each specialized TB center has a trained chest
  specialist, lab with a trained lab technician,
  and has a pharmacy containing anti-TB drugs.

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Prison Sector

• Cooperation between the NTP and the prisons began
  in 1997.
• By the end of 2002, to consolidate and formalize
  the collaboration, the NTP and the Ministry of
  Interior signed a protocol for the detection and
  treatment of TB prisoners.

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The universities

• The universities are opinion and professional
  leaders for doctors in private practice.
• Partnership with universities includes activities
  such as
• Research.
• providing educational material and influencing
  the medical professional associations.
• Orientation meetings for private providers.
• .

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Fever Hospitals

• In 2002 the NTP met with the leaders of the
  prophylactic medicine department in the MOHP and
  the managers of eight fever hospitals in Cairo
  and other governorates.
• An agreement was reached to design a protocol to
  put down the rules that guide collaboration.
• This protocol includes an agreement on case
  definition, case suspicion, proper case and case
  diagnosis.
• A particular focus is the management of extra
  pulmonary tuberculosis, which is commonly treated
  in fever hospitals.

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Teaching hospitals

• In 2002, collaboration between the NTP and the
  teaching hospitals and institutes was initiated.
• A protocol was signed to put down the rules that
  guide collaboration.
• This protocol includes an agreement on detection
  and notification of cases to the NTP.

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Ministry of Social Affairs

• Ministry of Social Affairs is responsible for
  providing social support to TB patients.
• The NTP has had a key role in the training of
  social workers posted at chest facilities.
• NTP, realized that social workers are also a key
  resource in developing health education material
  and in the social aspects of TB.

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Ministry of Information

• The Ministry of Information has provided
  important support to the NTP by providing free
  broadcasting of TV and radio spots with messages
  about TB.
• In addition they have had a role in ensuring a TB
  focus in different health programs on radio and
  television.
• They have also assisted the NTP in the
  organization of the health education campaign.

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Thank you