Decentralization towards elimination Datuk Dr. Muhammad Radzi Abu - - PowerPoint PPT Presentation

30th July 2020

Decentralization towards elimination

Datuk Dr. Muhammad Radzi Abu Hassan, Ministry of Health, Malaysia World Hepatitis Day webinar

HEAD-Start: driving HCV elimination in Malaysia

Hepatitis C Elimination through Access to Diagnostics (HEAD- Start) addresses both technology and implementation gaps

Simplification Decentralization Integration Malaysia

Settings

▪ Secondary and primary facilities ▪ National reference laboratory

Activities

▪ Hub-spoke model with decentralized confirmation ▪ Integration in existing polyvalent central platforms

Saving lives, reducing health system costs

◼Over 7,000 life-years saved ◼US$1.2 million saving to the Malaysian health system – Risk-based screening vs general screening generates high yield and reduces cost to find 1 positive case from >$40 to <$7

15,413

people screened

2,064

identified for confirmatory testing

75%

received confirmatory testing

75%

linked to treatment

Driving national policy change in support

• f WHO 2030 elimination targets

Evidence and experience from HEAD-Start helped form the basis of MOH implementing decentralized HCV care cascade in all PHC sites beginning January 2020. Decentralization of HCV care cascade requires continuous efforts and multipronged strategy working with different arms within the healthy ministry - primary care, public health, specialists and pharmaceutical division

Simplification of the national algorithm by introducing HCV RDTs Decentralization and Integration of HCV screening using RDTs at primary healthcare sites as part of standard care Decentralization of DAA treatment and task sharing between specialists at tertiary level and non- specialists at PHC level

Reduced time to first result from up to 6 months to 15 minutes HEAD-Start PHC sites were the first in the country to use RDTs for HCV

• screening. MOH has adopted this since

Dec 2019 as part of standard of care and has now expanded to other sites HEAD-Start PHC sites were the first to be trained in country for decentralized DAA treatment with DAA allocations received starting Sept 2019

Thank you!

Our HEAD- Start partners and collaborators:

FIND would like to express thanks to all people who participated in our studies

Technical collaborators and guidance A project funded by

Hospital Sultanah Bahiyah Hospital Raja Perempuan Zainab II Hospital Ampang Hospital Selayang Hospital Sungai Buloh Klinik Kesihatan Ayer Hitam Klinik Kesihatan Bakar Arang Klinik Kesihatan Bandar Alor Setar Klinik Kesihatan Bandar Sungai Petani Klinik Kesihatan Kuala Kedah Klinik Kesihatan Pendang Klinik Kesihatan Bandar Kota Bharu Klinik Kesihatan Bandar Tumpat Klinik Kesihatan Ketereh Klinik Kesihatan Kuala Krai Klinik Kesihatan Manek Urai Klinik Kesihatan Pengkalan Chepa Klinik Kesihatan Wakaf Bharu Klinik Kesihatan Kuala Lumpur Klinik Kesihatan Jinjang Klinik Kesihatan Pandamaran Klinik Kesihatan Salak Klinik Kesihatan Setapak Klinik Kesihatan Ampang Klinik Kesihatan Cheras Klinik Kesihatan Putrajaya Presint 9 Klinik Kesihatan Rawang Klinik Kesihatan Seri Kembangan Klinik Kesihatan Sungai Buloh Klinik Kesihatan Taman Medan