TPT Mentorship Checklist for HIV/TB Program Quality Assessment
Explore the TPT mentorship checklist designed to ensure high-quality integrated HIV/TB services are maintained. Assessing knowledge implementation, drug management, and monitoring and evaluation processes. Check out this comprehensive guide for sustaining program gains and service excellence.
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www.cquin.icap.columbia.edu TPT Mentorship Checklist Brian Kwizera MOH, Rwanda Biomedical Centre CQUIN 7thAnnual Meeting November 13 17, 2023 | Johannesburg, South Africa
Introduction TPT was initiated in 2019 for newly diagnosed HIV+ due to the limited infrastructure needed to diagnose active TB. In July 2020, the TWG concluded that TPT was scalable even with limited infrastructure e.g. X-ray. Rwanda embarked on a country-wide TPT scale-up starting with high HIV and TB prevalent areas and TPT availability. 30/30 districts have been trained and provided with the necessary skills and commodities to integrate TPT into HIV service delivery in a one-stop shop model. As of June 2023, 88.7% (193,724) of PLHIV have been initiated on TPT, with significantly high completion rates of 95%.
TPT mentorship checklist To sustain HIV/TB program gains and provide high- quality integrated HIV/TPT services, the program has developed a TPT mentorship checklist to assess whether the standards and quality of TPT services are being met. The TPT mentorship checklist assess four implementation areas: Knowledge implementation processes Drug management and Monitoring and Evaluation
TPT implementation process Knowledge of TPT Delivery Observation: Randomly check 10-20 client files for: o Is TPT/HIV One-stop shop functional? o Where are TPT services provided? o Proportion of trained ART and TB staff,? o Is IEC around TPT provided to all PLHIV? o Any Onsite training conducted? o Did all receive TB screening-5 questions? o Availability of guidelines and algorithms? o Is Diagnostic follow-up for presumptive TB done? o Probe questions to assess: o Patient Follow-up: Review TPT register and patient file for: Knowledge on TPT initiation criteria? % of PLHIV respect of appointment? Describe TPT algorithm? % PLHIV screened for TB at every clinical visit? Rate Adherence? Evaluated period/ month # Of Screened using symptoms (5 Questions) # Xpert performed among screened positive # CRX performed among screened positive with Gxp negative result Observations (if CXR is not performed to all eligible cases provide reasons) Norma Abnor done done done Not Not Not Neg Neg mal Pos Pos Pos l
Drug Management Obeservtion: Assess for adequate supply and stockout of TPT; Monitoring and Evaluation o Stock card available and completed? o Observation: Are recommendations from o Calculation of minimum stock? central/hospital level implemented? o Has there been a stockout? If yes, how long? Why? o Availability of TPT tools-TPT charts, register, o Adverse events on TPT at each clinical visit? guidelines, algorithms? And completeness? o Use of grading scale for classification of side effects? o HMIS monthly report status? Documentation, o Probe questions to assess knowledge on criteria for TPT discrepancies, Assess for timely submission of TPT interruption and restart? reports? o Proportion of clients with side effects? Neuropathy or Hepatotoxicity Grades?
Feedback-Action Specifics challenges Strategies proposed to address challenges observed Timeline Responsible CQUIN 7th Annual Meeting | November 13-17, 2023
www.cquin.icap.columbia.edu Thank you!
