National Tuberculosis Center

PAL Nepal

PRACTICAL APPROACH TO LUNG HEALTH (PAL)

With technical and financial assistance of WHO NTP initiated PAL in two districts of Nepal (Bhaktapur and Nawalparasi) in May 2007 as a pilot project.

This initiative is to address the management of respiratory patients in primary health care (PHC) settings while expending TB detection and quality TB services. PAL focuses on the most prevent respiratory diseases at level health facilities such as pneumonia, acute bronchitis and other acute respiratory infections, pneumonia, tuberculosis and chronic reparatory conditions including chronic bronchitis, asthma and chronic obstructive pulmonary disease (COPD).

PAL looks for an integrated case management of respiratory patients in PHC on the basis of two main approaches: Standardization of diagnosis and treatment of respiratory conditions, and coordination among health workers of different levels.

A National Working Group (NWG) on PAL was established in August 2007 in order to gain commitment and develop consensus sensitization meetings were held with policy makers and managers.

The PAL guideline and training materials were adopted and finalized after review by PAL NWG. The smoking cessation modules were included separately for health workers. The PAL OPD register and smoking cessation recording register are prepared to record the respiratory cases along with smoking status and progress of smoking cessation.

In the pilot districts namely Bhaktapur and Nawalparasi, all PHC, HPs and OPD of Bhaktapur and Parasi hospitals and NTC are implementing PAL.

Peak Flow Meter and other equipments are supplied to all health facilities in the pilot districts.

So far a team of 17 master trainers was developed at Central and Western Region levels and a total of 117 staffs were trained from 24 health facilities of participating districts and NTC.

Coordination among NTP and HMIS to integrate PAL recording and reporting system is on going. Continuous Supportive supervision and monitoring are needed to sustain the project.

Funds for expansion of PAL initiative to further five districts over next five year period are available to NTP through Global Fund Round 7 grant. Expansion of PAL is being started from early 2009.

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