Ardian M, Meokbun E, Siburian L, Malonda E, Waramori G, Penttinen P, Lempoy J, Kenangalem E, Tjitra E, Kelly P M
District Ministry of Health, Timika, Indonesia.
Int J Tuberc Lung Dis. 2007 Oct;11(10):1101-7.
A district-level tuberculosis (TB) control programme in Papua Province, Indonesia.
To describe a successful partnership between the District Health Department, a private company and non-governmental health care providers.
Routinely collected surveillance data were analysed. A conceptual model was constructed to describe TB control in the district. Data were compared with the National TB Control Programme (NTP) performance indicators.
Funding for the programme's TB clinic is provided by a private company (PT Freeport Indonesia). The NTP provides the policy framework, treatment guidelines and some supplies. TB clinic staff are included in training programmes and the TB laboratory in the provincial quality assurance system. TB clinic staff are responsible for diagnosis, treatment, default tracing, recording and reporting, health education and community mobilisation. The largest proportion of TB patient referrals came from the community hospital (41%). The TB notification rate (311/100000), TB-HIV (human immunodeficiency virus) co-infection (12%) and multidrug-resistant (MDR) TB (2%) are significantly higher in Mimika, but the treatment success rate for smear-positive patients (91%) is similar to Indonesian national figures.
For true progress in attaining the United Nations Millennium Development Goals for TB in Indonesia, innovative local solutions utilising public-private partnerships are essential. The Mimika model is one such solution that should be tested elsewhere.
印度尼西亚巴布亚省的一个地区级结核病控制项目。
描述地区卫生部门、一家私营公司和非政府医疗服务提供者之间成功的合作关系。
分析常规收集的监测数据。构建一个概念模型来描述该地区的结核病控制情况。将数据与国家结核病控制项目(NTP)的绩效指标进行比较。
该项目结核病诊所的资金由一家私营公司(印尼自由港公司)提供。NTP提供政策框架、治疗指南和一些物资。结核病诊所工作人员被纳入培训项目,结核病实验室被纳入省级质量保证体系。结核病诊所工作人员负责诊断、治疗、追踪失访患者、记录和报告、健康教育及社区动员。结核病患者转诊的最大比例来自社区医院(41%)。米米卡地区的结核病通报率(311/10万)、结核病-人类免疫缺陷病毒(HIV)合并感染率(12%)和耐多药结核病(MDR-TB)率(2%)显著更高,但涂片阳性患者的治疗成功率(91%)与印度尼西亚全国数据相似。
为在印度尼西亚实现联合国结核病千年发展目标取得真正进展,利用公私伙伴关系的创新地方解决方案至关重要。米米卡模式就是这样一种应在其他地方进行检验的解决方案。