Timor-Leste National Health Sector Strategic Plan 2011-2030

3 UNDP 2010 Human Development Report

4 Current health data derived from 2009 and 2010 An- nual Health Reportand Demographic Health Survey. NATIONAL HEALTH SECTOR STRATEGIC PLAN 2011-2030 ! 4 9W''N"#),!"&'()"&#( 31'".'0'-*"<'$+9.#%10"7'#&*1"8/.C'=",-),0#*'(#"(*#?&'")'0.'#('"+-"$#*'.-#&"$+.*#&,*=".#*'";.+$" __VqYVVDVVV".'%+.*')",-"UVVZ"*+"^^gqYVVDVVV",-"UVYVD"!-"*'.$("+;"-'+-#*#&")'#*1(>"+/*"+;"Y_V" -'+-#*#&")'#*1(".'%+.*')>"$+.'"*1#-"WVDWl"-'+-#*#&")'#*1("#.'"#*"#9'"+;"V4_")#=(D"<,&,".'%+.*')" *1'"1,91'(*"-'+-#*#&")'#*1("PUV"-'+-#*#&")'#*1(Q",-"*1'"='#."UVYVD"31'"$#B+.""0+$%&,0#*,+-("+;" %.'9-#-0=".'%+.*')"#.'"1'$+..1#9'>"'0&#$%(,#>"+?(*./0*')"&#?+."#-)"('%(,(D"E"0+$%&,0#*,+-"+;" %.'9-#-0="+-"1'$+..1#9'",(".'%+.*')"?="^VDUlD f ig.1: Delive ry Assis ted by Skilled Heall11 Sta ff in Timor Leste,.2006-20111 100% 80% 60% 40% 20% 0% 2006 2007 2008 2009 2010 S,9/.'"#?+C'"(1+A("%.+9.'((,C'",-0.'#('",-"#((,(*')")'&,C'.,'(";.+$"Ugq",-"UVV_"*+"#-"#C'.#9'"+;" aWDZl".'%+.*')",-"UVYVK>"A,*1"(+$'"),(*.,0*(".'%+.*,-9"#"(*#99'.,-9"%.+9.'(("*+"_fDfl",-"c#/0#/>" _UDal",-"<,&,"#-)"c+?#-#.+"^WDUl"+;")'&,C'.,'("#((,(*')"?="#"(H,&&')"1'#&*1"%.+;'((,+-#&>"A1,&'" (+$'"),(*.,0*("%.'('-*"&+A'."%'.;+.$#-0'D 99W''+($&I'()"&#('R'$NNM!$Z"#$%! 31'.'" 1#(" ?''-" #" (*'#)=" %.+9.'((" ,-" 01,&)" 1'#&*1" 0#.'>" A,*1" *1'" 0/..'-*" ,-),0#*+.(" (1+A,-9" #" ".')/0*,+-"+;"/-)'"2C'"$+.*#&,*=".#*'(";.+$"YY^qYVVV",-"UVVZ"*+"_aqYVVV",-"UVYV"#-)"#-",$%.+C'$'-*" ,-",-;#-*"$+.*#&,*=".#*'";.+$"fZqYVVV"*+"a^qYVVV")/.,-9"*1'"(#$'"='#.(D 31'" ,-),0#*+.(" ;+." *1'" !-*'9.#*')" @#-#9'$'-*" +;" M1,&)1++)" !&&-'((" P!@M!Q%.+9.#$" (1+A" *1#*" "3,$+.'('" 01,&).'-" #.'" 0+-;.+-*')" A,*1" *1.''" $#,-" )'('#('(r" :-'/$+-,#>" <,#..1'#>" @#&#.,#" #-)"*+*#&"M#('("3.'#*')D"@+.'"*1#-"YVl"+;"01,&).'-"s^",-"E,&'/>"c#/0#/>"c+?+-#.+>"M+C#&,$#>" "@#-#*/*+>"]'0/((,"#-)"`,R/'R/'"#.'"*.'#*')";+."<,#..1+'#D"!*".#-9'(";.+$"aDYl",-"5#/*'$"*+" YWDgl",-"]'0/((,D"31'"#C'.#9'"-/$?'."+;""01,&).'-"s^"*.'#*')";+."@#&#.,#",("WDVlD"!*".#-9'(";.+$" YDZl",-"E,-#.+"*+"U_Dal",-"`,R/'R/'D"E,&'/>""M+C#&,$#>"<,&,>"5#/*'$>"@#-#*/*+"#-)"`,R/'R/'"1#C'" $+.'" *1#-" YVl" +;" s^" 01,&).'-" *.'#*')" ;+." @#&#.,#D"E9#,->" YVDYl" +;" s^" 01,&).'-" #.'" *.'#*')" ;+." :-'+$+-,#",-0&/),-9"E0/*'":-'+$+-,#D"!*".#-9'(";.+$"ZDV",-"E,-#.+"*+"UUD^l",-"c#/0#/D"c#/0#/>" c+?+-#.+>"M+C#&,$#>"@#-#*/*+"#-)"`,R/'R/'"*.'#*')"$+.'"*1#-"Y^l"+;"01,&).'-"s"^D" 52010 Health Statistic Report. 5 *)+#$%!'$F'*$#M"#$%!'"!"&O*$* ! S+."*1'"A1+&'"0+/-*.=>"UVYV"0+C'.#9'"+;"$'#(&'(",$$/-,I#*,+-".'#01')"__DUlD"31.''"+/*"+;"YZ" ),(*.,0*("Pc+?+-#.+>"@#-#*/*+"#-)"`,R/'R/'Q"1#C'"$'#(&'("0+C'.#9'"1,91'."*1#-"fVl"#-)"*1.''" ),(*.,0*("PE,&'/>"<,&,"#-)"5,R/,0#Q"1#C,-9"$'#(&'("0+C'.#9'"?'&+A"_VlD"S+/."),(*.,0*("Pc+?+-#.+>" @#-#*/*+>" ]'0/((," #-)" `,R/'R/'Q" 1#C'" 1,91'." *1#-" fVl" #-)"3A+" ),(*.,0*(" PE,&'/" #-)"E,-#.+Q" "1#C,-9"?'&+A"_VlD"cMb"M+C'.#9'",("(&,91*&="1,91'."*1#-"$'#(&'(>"A,*1"gUDalD 31'"UVVW"0+C'.#9'"+;"<:347'%cZ",$$/-,I#*,+-"PgUDalQ",("(&,91*&="&+A'."*1#-"]:`Z"0+C'.#9'" PgUDUlQD"3A+"),(*.,0*("PE,&'/"#-)"5,R/,0#Q"1#C,-9"<:347'%cZ"0+C'.#9'"?'&+A"_Vl>"#-)";+/."+/*" YZ" ),(*.,0*(" "P@#-#*/*+>" @#-/;#1,>" ]'0/(('>" #-)" `,R/'R/'Q" .'#01')" <:347'%cZ" ,$$/-,I#*,+-" $+.'"*1#-"fVlD""M+C'.#9'"+;"<:347'%cZ",$$/-,I#*,+-",("(&,91*&="1,91'.",-"S'$#&'"*1#-"@#&'" :):<.-%")#? !-" *1'" 0#('" +;" *'*#-/(" *+G+,)" ,$$/-,I#*,+-" ;+." %.'9-#-*" A+$'->" UVYV" 0+C'.#9'" ;+." *1'" A1+&'" "0+/-*.=";+."33Ut",("ZUD^lD"M+C'.#9'"#0.+(("),(*.,0*"C#.,'(";.+$"_DWl",-"E,&'/"*+"_VDUl",-"`,R/'R/'D f'lg. 1. : DellVM'}' Asslst@d by Skill ;,d H@alth Staff In Timor L@ste,2.li OG,.20111 2006 2007 2008 2009 2010 999W''!M#,$#$%! :.'C#&'-0'" +;" /-)'.4A',91*" #$+-9" 01,&).'-" /-)'." 2C'" ='#.(" +&)" ,(" ZfD^l>" A,*1" 7@!8" )#*#" "(1+A,-9"),;;'.'-*")#*#"*+"*1'"+-'";+/-)",-"*1'"<78"UVYV#*"^Ul>"*1/(>"(1+A,-9"+-0'"$+.'"*1'" -'')"*+",$%.+C'"1'#&*1"$#-#9'$'-*",-;+.$#*,+-"(=(*'$D"31'"1,91'(*"&'C'&("+;"/-)'.4A',91*"#.'" ,-"E,&'/"#-)"]'0/(('"A,*1"^Vl"+;"/-)'.4A',91*#$+-9"01,&).'-"&'(("*1#-"2C'"='#.("+&)"+;"#9'D" :.'C#&'-0'"+;"8'C'.'"@#&-/*.,*,+-"#$+-9"01,&).'-"/-)'."2C'"='#.("+&)",("Y^DZlD" @#&-/*.,*,+-" .'$#,-(" #" C'.=" ('.,+/(" %.+?&'$" #-)" *+" ';;'0*,C'&=" 0+$?#*,-9" *1,(" %.+?&'$" ,-" "3,$+.45'(*'"A,&&".'R/,.'"1',91*'-')"#**'-*,+-"*+"*1'"-/*.,*,+-#&"-'')("+;"A+$'-")/.,-9"%.'9-#-0=" #-)"+;"01,&).'-",-"*1'"2.(*"*A+"='#.("+;"*1',."&,C'(D 9SW''N"&",$" !-"UVYV>"*1'"$#&#.,#",-0,)'-0'"A#("YVa>UqY>VVV"%+%/&#*,+-(D"31'"1,91'(*",-0,)'-0'".#*'"+;""$#&#.,#" #.'" #$+-9" 01,&).'-" /-)'." Y" PU__>^qY>VVV" %+%/&#*,+-Q" ;+&&+A')" ?=" 01,&).'-" Y" u" a" ='#.(" +;" #9'" PYgf>fqY>VVV"%+%/&#*,+-QD" 31'"*+*#&"0#('("0+-2.$')"%+(,*,C'A'.'Zf>_l"#-)"#$+-9"*1'"%+(,*,C'(>"ga>Vl"A'.'":D""S#&0,%#./$>" U^>U"A'.'":D"`,C#G"#-)"V>f"A'.'"@,GD" NATIONAL HEALTH SECTOR STRATEGIC PLAN 2011-2030 ! 6 Fi1. 3: Numbe-r of Malaria Cases by month in Timor-Leste-, 2005 t o 2010 25000 20000 15000 10000 5000 0 Jan Feb Mar Apr M ay Jun Jui Aug Sep Oct Nov Des -----+--- 2005 ---♦- 2006 ----+- 2007 - - 2008 ~ - 2009 ----+- 2010 E&*1+/91"*1'.'"#.'",$%.+C'$'-*(",-".'&#*,+-"*+"%.'C,+/("='#.(>"*1'"$+.?,),*=".#*'"#$+-9"%.'9-#-*" A+$'-",("/-)'.4.'%+.*')>",-"UVYV"(1+A("Zga"$#&#.,#"0#('("#$+-9"%.'9-#-*"A+$'-".'%+.*')" ?="M7M("#-)"7:D"@#-#*/*+"P^Y"0#('(Q"#-)"<,&,"Pa^"0#('(Q"),(*.,0*(".'%+.*')"-/$?'."+;"$#&#.,#",-" %.'9-#-*"A+$'-D SW''#MJ),+M&%*$* !-"UVYV>"*1'"$+.*#&,*=")/'"*+"3/?'.0/&+(,("P3cQ"A#(".'%+.*')"#*"agqYVVDVVV"%+%/&#*,+-"#-)"Y>^ZV" 6'A" 8$'#." :+(,*,C'" P68:Q" 0#('(" A'.'" .'9,(*'.')" +-" <]38D"31'" #--/#&" 68:" 0#('" )'*'0*,+-" .#*'"A#("WYDfl"#9#,-(*"*#.9'*"+;"gVlD"31'"*+*#&"+;"#&&"*=%'("+;"3c"0#('",-0&/),-9"8$'#."-'9#*,C'" #-)"'G*.#4%/&$+-#.="3c".'9,(*'.')"+-"<]38"*.'#*$'-*";+."*1'"='#."UVYVA#(a>faYD""]/*"+;"*+*#&" -'A"%/&$+-#.="3c"0#('("".'9,(*'.')>"ZaDgl"#.'"-'A"(%/*/$"%+(,*,C'"0#('(D"31,(",(")/'"*+"+C'." ),#9-+(,("+;"($'#."-'9#*,C'"0#('("?#(')"+-"/-)/'".'&,#-0'"+;"j4.#="#("%.,$#.="*++&";+."),#9-+(,(" ?="$'),0#&"(*#;;"#-)")/'"*+"(/?4+%*,$#&"R/#&,*="+;"(%/*/$"$,0.+(0+%="&'#),-9"*+"/-)'.4),#9-+(,(" +;"-'A"($'#."%+(,*,C'"0#('(D" 31'" *.'#*$'-*" (/00'((" .#*'" ;+." *1'" 0+1+.*" A#(" f_l" 0+$%#.')" *+" 9&+?#&" *#.9'*" +;" f^lD" 31'" "*.'#*$'-*"(/00'((".#*'"0+/&)"1#C'"?''-";/.*1'.",$%.+C')",;"*1'")';#/&*".#*'"+;"al"0#-"?'".')/0')" *1.+/91"%.+%'."$#-#9'$'-*"+;"*.'#*$'-*>"R/,0H")';#/&*".'*.,'C#&>"#)).'(("C'.,20#*,+-"#*"*1'"*,$'" +;",-,*,#*,-9"*.'#*$'-*"#-)"%.+%'."%#*,'-*"#-)";#$,&="0+/-('&,-9"?="1'#&*1"(*#;;D l'ig, 4: TB Case Detection and Outcome for Treatment in Timor•Leste, 2000·2010 100 92 90 80 70 60 50 40 50 45 30 35 - case Detection rate 20 ~ Treatment Sucx:es r ate 10 0 2002 2003 2004 2005 2006 2007 2008 2009 2010 7 *)+#$%!'$F'*$#M"#$%!'"!"&O*$* ! S9W''($K>"$I* 31'.'" #.'" UYY0/$$/&#*,C'" 0#('(" +;" 7!`" ,-;'0*,+-" .'%+.*')" *+" *1'" 6#*,+-#&" 7!`qE!<8" /-,*?=" UVYV>"+;"A1,01"UZ")'#*1(>"^V"-'A"7!`",-;'0*,+-".'%+.*')",-"*1'"='#."UVVW>"#-)"ZY"0#('("/-)'." "#-*,4.'*.,C,.#&" "*.'#*$'-*" PEd`QD"31'" $#B+.,*=" +;" .'%+.*')" 7!`" ,-;'0*,+-(" #.'" A,*1,-" #9'" 9.+/%" +;" Y^"u"Ua"='#.("PU_DYVlQ"#-)"U^"u"aa"='#.("P_^DWlQD"!-"UVYV>"*1'.'"A'.'"_V"-'A"0#('(",)'-*,2')D FIC, S: N1.11uberof HIV/ AIDS cases Detection by Age Group, Year.s 2000.•2 010 140 uo 100 80 ■ ARVTreatmer>t 60 ■ Oe~th 40 lO 0 <Syea,s S-14years l S-24;,ears 2S-44;,ears >45 years Oki S99W''%#(),'+%NNM!$+"J&)'I$*)"*)* M%,(+),0"+/*?.'#H("+;")'-9/'"1'$+..1#9,0";'C'."P<7SQ"#.'"0+$$+-"A,*1"*1'"$+(*".'0'-*"+-'" "+00/..,-9",-"UVV^")/.,-9"A1,01"*,$'"*1'"0#('";#*#&,*=".#*'"%'#H')"#*"YalD"!-"T#-/#.="UVYV>"fZ" 0#('(" +;" <7S" A'.'" ;+/-)" ,-" ;+/." ),(*.,0*(r" c+?+-#.+" P_^" 0#('(Q>" <,&," PY^" 0#('(Q>" @#-#*/*+" PU" 0#('(Q>"#-)"E,-#.+"PY"0#('QD" 31'.'"#.'"Uf0#('("+;":c"#-)"^W"0#('("+;"@c"0#('(D"M#('("+;":c"#-)"@c"#.'"1,91",-"vY^"#9'" 9.+/%"*1#-",-"sY^"#9'"9.+/%D31'"#C'.#9'"5#%.+(=":.'C'&'-0'".#*'";+."3,$+.45'(*'",("_fDVl"%'." YV>VVV"%+%/&#*,+-("A,*1"0#('")'*'-*,+-".#*'",("VDga"%'."YV>VVV"%+%/&#*,+-(D"5'%.+(="%.'C#&'-0'" .#*'".#-9'(";.+$"VDag",-"E,-#.+"*+"gDaV",-"]'0/(('D"<!&,>"]'0/(('"#-)"`,R/'R/'"1#C'"$+.'"*1#-" U"%.'C#&'-0'".#*'"%'."YV>VVVD"31'"0#('")'*'0*,+-".#*'".#-9'(";.+$"VDYf",-"@#-/;#1,"*+"_DfU",-" ]'0/(('D Fig. 6 : Nurnberof Leprosy case Notification in Titnor-Leste,2003-2010 600 493 500 - case Detection ~ % 400 aoo 200 154 157 100 1-79 5.18 3_11 1. 76 1. n L]!.4 0.73 0 ■ 2003 ■ 2004 ■ 2005 2006 ■ 2007 ■ 2008 • 2009 ■ 2010 NATIONAL HEALTH SECTOR STRATEGIC PLAN 2011-2030 ! 8 4,:&)$'1(L".-&"-$"$(-#8(L&-3@<$"-(-&,(,#8,3";("#($,9,&-.(8"$%&";%$("#(24?(2/,(3-P)&"%'()*(;-$,$( +00/.",-"*1'"0+#(*#&"&,-'",-0&/),-9"]'0/('>"c#/0#/>"`,R/'R/'>"@#-#*/*+>"#-)"@#-/;#1'D" S999W''!%!>+%NNM!$+"J&)'I$*)"*)* @+.*#&,*=" 0#/(')" ?=" -+-40+$$/-,0#?&'" ),('#('(" #.'" __ZqYVVDVVV" %+%/&#*,+-D" "M#.),+C#(0/&#." "),('#('(>"0#-0'."#-)"#00,)'-*("#.'"*1'"0#/('("+;")'#*1",-"Z_^>"W_>"#-)"fZ"%'."YVV>VVV"%+%/&#*,+-(" &,$:,;%"9,.'?( i-1'#&*1=" &,C,-9" 0+-),*,+-(>" A1,01" ,-0&/)'" #$+-9" +*1'.(>" +C'.0.+A),-9>" $#H'(1,;*" 1+/(,-9>" "/-(#;'" ).,-H,-9" A#*'.>" /-(#;'" A+.H,-9" 0+-),*,+-(>" %++." A#(*'" ),(%+(#&>" ;++)" ,-('0/.,*=" #.'" "$#**'.(" +;" %/?&,0" 1'#&*1" 0+-0'.-D" 5,C,-9" 0+-),*,+-(" #.'" #;;'0*')" ?=" &+0#&" #0*,+->" ?=" 0+$$/-,*=" 9.+/%("#-)""+.9#-,I#*,+-("#-)"?="*1'"A+.H"+;"&+0#&"9+C'.-$'-*(";+."A1,01"#"(=(*'$"$/(*"'G,(*"*+" '-#?&'""0+&&#?+.#*,+-"#-)""0++.),-#*,+-D"]-&="^Ul"%+%/&#*,+-"1#("#00'(("*+"0&'#-"A#*'."#-)"ZVl" %)(@-$";($-#"%-%")#?(2/"$(&,-."%'(3-Q,$(%/,(:):<.-%")#(3)&,(9<.#,&-@.,(%)(8"$,-$,$(."Q,(8"-&&/,-1( $#&#.,#>")'-9/'"#-)"+*1'.(D"E.+/-)"^Vl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otal Hospital Deaths 46 and Disease <1 1-4 5 - 14 15 - 45 No. of % of Total older deaths Hospital Deaths Bronchopneumonia/Pneumonia 37 26 12 25 36 136 11.5 All forms of TB 3 5 18 75 75 176 14.9 Malaria 6 8 18 22 4 58 4.9 Cardiovascular Disease 1 1 1 14 21 38 3.2 Injury 0 1 5 19 9 34 2.9 Liver Disease 1 0 0 12 19 32 2.7 Cerebrovascular Disease 0 0 0 11 20 31 2.6 Renal Disorder 2 0 10 7 11 30 2.5 Diarrhoeal Diseases 10 10 1 7 1 29 2.4 Asthma Bronchiale/COPD 1 0 1 7 17 26 2.2 Meningitis/Encephalitis 2 4 4 7 0 17 1.4 Malnutrition 4 9 0 1 0 14 1.2 Anemia 1 2 0 10 0 13 1.1 9 *)+#$%!'$F'*$#M"#$%!'"!"&O*$* ! $WB''%,C"!$Z"#$%!'%G'#()'()"&#('*)+#%, !-"+.)'."*+"%/.(/'",*("$,((,+-"+?B'0*,C'(>")'0+-0'-*.#*,+-"+;"*1'"@,-,(*.="+;"7'#&*1;/-0*,+-("?'9#-" A1,&'"+%'.#*,-9"#*";+/."('.C,0'"&'C'&("u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i::]d3"e"3dE68SXd"8y83X@ @E6EbX@X63" "8i::]d38Xd`!MX8 6#*,+-#&"<,#9-+(*,0" <,&,"6#*,+-#&" 8'.C,0'( I ◄-► MX63dE5"8Xd`!MX8 +)$:"%-. ··------------·-----------··--------- J + Pd#),+&+9=>"&#?+.#*+.=Q -------·-----------------i -------------, ! 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'#01" &'C'&D" ]*1'.(" 0+$%+-'-*(" (/01" #(" 0+$%'*'-*" #-)" #)'R/#*'" -/$?'." #-)" *=%'" +;" 1'#&*1" :&)*,((,+-#(>"#%%.+%.,#*'",-;.#(*./0*/.'>"$'),0#&"'R/,%$'-*("#-)"+*1'.("$'#-,-9"+;"(/%%+.*"#.'" ,$%+.*#-*"*+"9/#.#-*''"*1'"R/#&,*="#-)"';;'0*,C'-'(("+;"1'#&*1"('.C,0'("%#0H#9'("%.+C,(,+-"(1+/&)" @,(8,9,.):,8? "W''*$*+/'^'c#(,0"1'#&*1"('.C,0'("%.+C,)')"?="M7M(".'#01,-9"+/*"*+"0+$$/-,*,'(";+&&+A,-9"*1'" principle of community empowerment to address key health needs at aldeia level. %Ed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xpected Results/ Key Indicators: YD" YVVl"+;",$%&'$'-*#*,+-"+;"_"*#?&'("?="UVY^| UD" ^Vl"+;"8!8M#"%+(*(",$%&'$'-*"*1'";+&&+A,-9";/-0*,+-#&"'&'$'-*(r"#Q"<#*#?#('"Pd8S43#?DYQ|"?Q" 7'#&*1"M#.'"E((,(*#-0'"P3#?D"U4_Q| ZD" d+/*,-'"8/.C'="#-)")#*#"#-#&=(,(?="UVY^| aD" 31'"*1.''";/-0*,+-#&"'&'$'-*("+;"8!8M#"#.'"YVVl",$%&'$'-*')"?="UVZV",-"#&&"8!8M#":+(*(D Target Target Target Target Strategy Indicator 2015 2020 2025 2030 Strengthen community empowerment in participating and % SISCa post management 1. to take lead in the identification led by community leaders 50% 100% 100% 100% of health issues and practices that hinders access to health services. 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DISTRICT HOSPITAL – General hospital services providing four specialized areas as the referral for primary health care at District level. %Ed4U69S4F'' *+"%.+C,)'"9'-'.#&"1+(%,*#&"('.C,0'("#?&'"*+"0+$%&'$'-*"0+$%.'1'-(,C'"%.,$#.="1'#&*1" ;-&,? *60/64T942F YD" X(*#?&,(1$'-*"+;"9'-'.#&"1+(%,*#&"('.C,0'(",-"'#01"),(*.,0*| UD" <'C'&+%"(/%%+.*,-9"$'01#-,($(";+."%.+C,(,+-"+;"%.'C'-*,C'>"0/.#*,C'"#-)".'1#?,&,*#*,C'"0#.'" ;+&&+A,-9"-#*,+-#&"9/,)'&,-'(| ZD" 8*.'-9*1'-".';'..#&"%#*1A#=(";+."#&&"&'C'&("+;"1'#&*1"0#.'| aD" 8/%%+.*,-9"%.'4('.C,0'"#-)",-4('.C,0'"*.#,-,-9";+."1'#&*1"%.+;'((,+-#&(| ^D" M+$$/-,*="'$%+A'.,-9*+%#.*,0,%#*')",-"1+(%,*#&"R/#&,*=",$%.+C'$'-*D NATIONAL HEALTH SECTOR STRATEGIC PLAN 2011-2030 ! 40 )W' ' ,)C$%!"&' (%*;$#"&^' E/*+-+$+/(" .'9,+-#&" 1+(%,*#&(" %.+C,),-9" ',91*''-" (%'0,#&,I')" ($,&9";,$(-$(%/,(&,*,&&-.(*)&(%/,(8"$%&";%(/)$:"%-.$? %Ed4U69S4F''%)(:&)9"8,($:,;"-."$,8(/)$:"%-.($,&9";,$(-@.,(%)(;)3:.,3,#%(;)3:&,/,#$"9,(:&"3-&'(-#8( $,;)#8-&'(/,-.%/(;-&,? *60/64T942F YD" X(*#?&,(1$'-*"+;"(%'0,#&,I')"1+(%,*#&"('.C,0'(",-"('&'0*')".'9,+-(| UD" <'C'&+%"(/%%+.*,-9"$'01#-,($(";+."%.+C,(,+-"+;"%.'C'-*,C'>"0/.#*,C'"#-)".'1#?,&,*#*,C'"0#.'" ;+&&+A,-9"-#*,+-#&"9/,)'&,-'(| ZD" 8*.'-9*1'-".';'..#&"%#*1A#=(";+."#&&"&'C'&("+;"1'#&*1"0#.'| aD" 8/%%+.*,-9"%.'4('.C,0'"#-)",-4('.C,0'"*.#,-,-9";+."1'#&*1"%.+;'((,+-#&(| ^D" X(*#?&,(1"1'#&*1".'('#.01"/-,*| _D" M+$$/-,*="'$%+A'.,-9"*+"%#.*,0,%#*')",-"1+(%,*#&"R/#&,*=",$%.+C'$'-*D GW''!/69-=/5'(-2<96/5^'E/*+-+$+/("-#*,+-#&"&'C'&"1+(%,*#&"%.+C,),-9"(/%.#"#-)"(/?"(%'0,#&,I')" $,&9";,$(-$(%):(&,*,&&-.(/)$:"%-.(*)&(%/,(;)<#%&'? %Ed4U69S4F''*+"%.+C,)'"(/%.#"#-)"(/?"(%'0,#&,I')"1+(%,*#&"('.C,0'("#?&'"*+"0+$%&'$'-*"0+$%.'4 /,#$"9,((:&"3-&'(-#8($,;)#8-&'(/,-.%/(;-&,? *60/64T942F YD" X(*#?&,(1$'-*"+;"#"(/%.#"#-)"(/?"(%'0,#&,I')"1+(%,*#&"('.C,0'";+."*1'"0+/-*.=| UD" <'C'&+%"(/%%+.*,-9"$'01#-,($(";+."%.+C,(,+-"+;"%.'C'-*,C'>"0/.#*,C'"#-)".'1#?,&,*#*,C'"0#.'"#*" 1+(%,*#&"&'C'&>";+&&+A,-9"-#*,+-#&"9/,)'&,-'(| ZD" 8*.'-9*1'-".';'..#&"%#*1A#=(";+."#&&"&'C'&("+;"1'#&*1"0#.'| aD" 8/%%+.*,-9"%.'4('.C,0'"#-)",-4('.C,0'"*.#,-,-9";+."1'#&*1"%.+;'((,+-#&(| ^D" X(*#?&,(1"1'#&*1".'('#.01"#-)")'C'&+%,-9"1'#&*1"*'01-+&+9=| _D" M+$$/-,*="'$%+A'.,-9"*+"%#.*,0,%#*')",-"1+(%,*#&"R/#&,*=",$%.+C'$'-*D 41 !"#$%&'(%/)(5"2%/".,(&0(1"-2$1(!"./%#"!(! *#,"#)C$+'I$,)+#$%!'G%,'(%*;$#"&'*),K$+)* #/0T46 #/0T46 #/0T46 #/0T46' *60/64T8 $=19U/6-0 ?@A_ ?@?@ ?@?_ ?@B@ l" +;" #C#,&#?&'" ;+/." 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"%#*1A#=( k" ]00/%#*,+-#&"1'#&*1"e"(#;'*= %Ed4U69S4F'*+"%.+)/0'"#)'R/#*'"-/$?'.("#-)"(H,&&("+;"*1'"),;;'.'-*"0#).'("+;"1/$#-".'(+/.0'(" *)&(%/,(/,-.%/($,;%)&? E("%'."-'A"%.+B'0*')"1'#&*1"('.C,0'("0+-29/.#*,+-"?="UVZV>"*1'(*.#*'9=(1+/&)".'(%+-)"*+"1'#&*1" "(=(*'$"(*.'-9*1'-,-9"?=";+0/(,-9"?+*1"+-"$#-#9'$'-*"#-)"0&,-,0#&"-'')("#("#"A1+&'D"31'="#.'r YD" X-(/.'"*1'"#C#,&#?,&,*="+;"7d";+."7'#&*1"<'C'&+%$'-*":&#-D UD" 3+")'C'&+%"*1'"0#%#0,*="+;"*.#,-,-9"#-)"')/0#*,+-",-(*,*/*,+-("+-"%.+)/0*,+-"+;"R/#&,2')"1'#&*1" /<3-#(&,$)<&;,$? ZD" M.'#*'" '-#?&,-9" '-C,.+-$'-*" *+" ,$%.+C'" %'.;+.$#-0'" #-)" A+.H" $+*,C#*,+-" +;" 'G,(*,-9" #-)" -'A&=".'0./,*')"A+.H;+.0'D 13Road Map for development of health professionals is attached in Annex C. 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D#;&,-$,( ;)33<#"%'( l"+;"(01++&("A,*1"(01++&" UVl aVl _Vl gVl '-9#9'$'-*" ,-" -/*.,*,+-" 9#.)'-(";+."-/*.,*,+-"')/4 "#%,&9,#%")#$ ;-%")#( -#8( $;/)).( 3,-.$( ;)#$<3:%")# l" +;" 1+/('1+&)(" A,*1" ZVl ^Vl gVl WVl 1+$'"9#.)'-( l" 0+$$/-,*=" $'$?'.(" Z^l gVl WVl D3:&)9, A,*1" ,$%.+C')" -/*.,*,+-" H-+A&')9' !-0.'#('" 0+C'.#9'" #-)" l" +;" %'+%&'" &,C,-9" A,*1" U^l ^Vl g^l D3:&)9, R/#&,*=" " *.'#*$'-*" +;" -/4 -/*.,*,+-#&" .'&#*')" -+-4 *.,*,+-#&".'&#*')"-+-40+$4 ;)33<#";-@.,( 8"$,-$,( 3<#";-@.,(8"$,-$, &,;,"9,("#%,&9,#%")# 101 $N;&)N)!#"#$%!'#$N)G,"N) %M#;M#' *#,"#)C$)* "+#$K$#$)* $!I$+"#%,* #/0T46 #/0T46 #/0T46 #/0T46 ?@A_ ?@?@ ?@?_ ?@B@ Implement WRA NFS % of health workers 9o%% Improve and Maintain Maintain education and counseling trained in adolescent nu- Maintain including health seeking trition behavior and food taboos ( before, during and after % of pregnant and lacta- 50% 75% 90% Maintain pregnancy) tion women receiving counseling % of adolescent receive 20% 40% 80% Maintain counseling on nutrition Introduce and implement under-two growth moni- % of health workers who toring with counseling 95% 95% 95% 95% understand how to use the and MUAC screening for WHO growth chart children 24-59 months % of health workers who 75% 90% Maintain Maintain provide counseling % of mothers receiv- ing counseling through 50% 75% 90% Maintain growth monitoring activi- ties % of children screened and 50% 70% 90% Maintain referred to health facilities Establish a national train- Establish national nutrition 1 NNTC estab- Maintain Maintain ing centre for nutrition training center (NNTC) Maintain lished and food security in coor- dination with agriculture % of health staff trained on and education sector nutrition and food security 90% Maintain Maintain Maintain % of health staffs enrolled into formal or informal 50% 75% 90% Maintain program (to build leader- ship and technical capacity in NFS) % Hospital equipped with HN: 2 MD special- clinical nutritionist (dieti- ist diet. 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IMPLEMENTATION TIMEFRAME STRATEGIES ACTIVITIES OUTPUT INDICATORS Target Target Target Target 2015 2020 2025 2030 Enhancing access to Government commitment supported by long- % of New smear positive TB diagnostic and term planning adequate human resources and registered out of esti- 75 80 85 90 treatment services sustainable financing mated New smear posi- that are accountable s develop medium and long-term budgeted tive cases. to clients and based plans of action in line with national health and on human rights ap- development plans % of new smear posi- >85 >85 >85 >85 proach s develop an evidence base on the impact of TB tive cases successfully interventions treated out of new smear positive registered. Case detection through quality assured bac- teriology and strengthening of the laboratory Number (%) of designat- YW"PYVVl) YW"PYVVlQ YW"PYVVlQ YW"PYVVlQ network ed microscopy centers s maintain a quality assured laboratory network that are part of external for sputum smear microscopy quality assurance pro- s develop capacity for culture and drug suscep- tocol tibility testing at NHL s ensure availability of supplementary diagnos- tics modalities at appropriate levels. Number (%) of districts 13 (100%) 13 (100%) 13 (100%) 13 (100%) s ensure adherence to the recommended diag- reporting no stock-out of nostic algorithms by all health care providers anti-TB drugs Access to standardized treatment, under proper Number of districts sub- 13 (100%) 13 (100%) 13 (100%) 13 (100%) case management conditions, including direct- mitting reports on time ly observed treatment and patient support to increase adherence, chance of cure, and reduce the risk of acquiring drug resistance s Uninterrupted supplies of quality assured anti-TB drugs and other consumables at all facilities s Accurate recording and reporting on all no- tified cases and their outcomes for efficient monitoring of programme performance and evaluation of impact of TB control interven- tions !"#$%&'(%8)(%372"3"'$-$%&'(-..-'4"3"'$! ! 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