ZuZusa da saSvilosnos yelis kibos skriningis programagnsc.ge/upload/files/2008.pdf · ZuZusa da...

wliuri angariSi 2008

ZuZusa da saSvilosnos yelis kibos skriningis programa

2


2008

sarCevi

I. mizani

II. resursebi

III. Sedegebi IV. finansuri implementacia V. momavali samuSao gegma

3


2008

standartuli angariSi proeqtis mimdinareobis Sesaxeb

qveyana: saqarTvelo

saangariSgebo periodi: 2008 wlis 01 maisi – 31 dekemberi

programis komponenti – reproduqciuli janmrTeloba

proeqtis saidentifikacio monacemebi (gamoiyeneT ATLAS kodi): proeqtis saxelwodeba da saidentifikacio nomeri (Tanadafinansebis mqone proeqtebisaTvis) : GEO1R21A / sarZeve jirkvlis da saSvilosnos yelis kibos skriningis programa

Tanadamfinansebeli donorebi: Tbilisis municipalitetTan arsebuli janmrTelobisa da socialuri daxmarebis departamenti/ gaeros mosaxleobis fondi (UNFPA)

programis komponentis xelmZRvaneli: Sromis, janmrTelobis da socialuri daxmarebis saministro

Semsrulebeli partniorebi: erovnuli skrining centri, UNFPA

Sesavali sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis programa warmoadgens Tanadafinansebis principiT SemuSavebul partniorul iniciativas romelic daido UNFPA/saqarTvelosa da Tbilisis municipaletTan arsebul socialuri daxmarebis da kulturis departaments Soris, romelic xorcieldeba saqarTvelos pirveli ledis patronaJiT .

2006 – 2007 wlebSi reproduqciuli traqtis kibos prevenciis sferoSi Tbilisis municipalitetisa da UNFPA – is partnioruli proeqtebis ganxorcielebis Sedegad miRebuli monacemebisa da gamocdilebis analizis safuZvelze 2008 wlis dasawyisSi moxda proeqtis dizainis Secvla da misi fokusireba Tbilisis samizne mosaxleobis sarZeve jirkvlis da saSvilosnos yelis kibos skriningze. aRniSnuli proeqtis gansaxorcieleblad SerCeuli iqna erovnuli skrining centri

4


2008

I. mizani

mosalodneli gamosavali: gaizarda mosaxleobis xelmisawvdomoba reproduqciuli janmrTelobis yovlismomcveli momsaxurebisa da amomwuravi informaciisadmi.

mosalodneli Sedegi: mosaxleobis, maT Soris axalgazrdebisaTvis, xelmisawvdomobis gazrda momxmarebelze orientirebuli yovlimomcveli samedicino momsaxurebisadmi jandacvis sistemis nebismier doneze. proeqtis miznebia:

sarZeve jirkvlisa da saSvilosnos yelis kiboTi gamowveuli sikvdilianobis Semcireba maTi adreuli diagnostikis meSveobiT;

samizne mosaxleobaSi sarZeve jirkvlisa da saSvilosnos yelis kibos adreuli diagnostikis maCveneblebis maqsimalurad gazrda;

samizne asakobrivi jgufebis qalebisaTvis sarZeve jirkvlisa da saSvilosnos yelis kibos skriningisadmi Tanaswori xelmisawvdomobis uzrunvelyofa;

samedicino momsaxurebisadmi xelmisawvdomobisa da mosaxleobis saWiroebebisadmi Sesabamisobis uzrunvelyofa;

programis menejmentis, momsaxurebis miwodebis, monitoringis, Sefasebis da angariSgebis maRali standartebis miRweva;

zemoT moyvanili miznebisa da amocanebis gansaxorcieleblad UNFPA mxars uWerda Semdeg RonisZiebebs:

proeqtis menejmenti;

erovnuli simZlavreebis Seqmna sarZeve jirkvlis da saSvilosnos yelis kibos skriningis sferoSi maRali xarisxis samedicino momsaxurebis uzrunvelyofis mizniT;

reproduqciuli traqtis skriningisa da kibos kontrolis sferoSi samedicino momsaxurebis mimwodebelTa erovnuli simZlavreebis Seqmna;

kibos prevenciisa da adreuli gamovlenis da sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis programis sargeblobis Sesaxeb mosaxleobis gaTviTcnobierebulobis donis gazrdaze orientirebuli sainformacio/sakomunikacio kampaniis Catareba .

5


2008

II. resursebi

proeqtis ganxorcielebis sawyisi biujeti – 345,856 aSS dolari proeqtis ganxorcielebis saboloo biujeti - 471,382.27 aSS dolari

dafinansebis wyaroebi: UNFPA da janmrTelobisa da socialuri daxmarebis departamenti ( HSAD )

ZiriTadi resursebi – sul sawyisi odenoba 80,000 aSS dolari

ara-ZiriTadi resursebi – sul sawyisi odenoba 356,508.27 aSS dolari

ZiriTadi resursebi – damxmare dafinanseba 32,500 aSS dolari

ara-ZiriTadi resursebi – 2007 wlidan programis gafarToeba 2,374 aSS dolari

ZiriTadi resursebi – sul saboloo odenoba 112,500.00 aSS dolari

ara-ZiriTadi resursebi - saboloo odenoba sul 358,882.27 aSS dolari

III. Sedegebi

1. proeqtis menejmenti

skriningis proeqtis efeqturi menejmenti efuZneba programis adekvatur marTvas, epidemiologiuri monacemebis saTanado analizs da samedicino informaciis kargad organizebul sistemas. proeqtis srulyofili marTvis uzrunvelyofis mizniT UNFPA –m samuSaod daiqirava Semdegi TanamSromlebi: proeqtis menejeri, romlis movaleobebsac Seadgens skriningis proeqtis saerTo zedamxedveloba, personalis marTva da personalis Semdgomi ganviTareba, xarisxis marTvis sistemebis uzrunvelyofa, biujetis marTva da strategiul partniorebTan kavSiris uzrunvelyofa; samedicino epidemiologi, romelsac evaleba skriningis programis meSveobiT mopovebuli monacemebis Segroveba da analizi, monacemebis analizis Sesasruleblad gamoiyenos standartuli statistikuri/epidemiologiuri meTodebi; sainformacio teqnologiebis specialistebi-maT movaleobebs Seadgens saxelmwifos mier Sesyiduli skriningis specialuri programis marTva, mocemul sferoSi problemebis identificireba, rekomendaciebis SemuSaveba proeqtis sainformacio teqnologiebis komponentis ganviTarebisa da srulyofisaTvis.

6


2008

2. nacionaluri simZlavreebis Seqmna sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis sferoSi maRali xarisxis samedicino momsaxurebis uzrunvelyofis mizniT;

UNFPA – s daxmarebiT citopaTologebis, histopaTologebis da molekularuli biologiis specialistebisaTvis Catarda seminari saSvilosnos yelisa da sarZeve jirkvlis daavadebaTa diagnostikis sakiTxebze. seminari Catarda amsterdamis (niderlandebi) vrJies universitetis samedicino centris wamyvani specialistebis mier.; seminarSi aseve aqtiur monawileobas iRebdnen erovnuli skrining centris TanamSromlebi. seminari organizebuli iyo “XXI paTologo-anatomebis asociaciebTan” partniorobiT. es iyo UNFPA/Tbilisis municipalitetis TanadafinansebiT mimdinare kibos prevenciis proeqtebis farglebSi (2006, 2007 da 2008 wlebSi) gamarTuli mesame yovelwliuri seminari. yovelive zemoT CamoTvlilis Sedegad Seiqmna adgilobriv

profesionalTa kadrebi, romlebic muSaoben qveynis sxvadasxva samedicino dawesebulebaSi, aseve moxda saqarTvelos regionebSi saSvilosnos yelis nacxis e.w. PAP testis, rogorc saSvilosnos yelis kibos skriningis meTodologiis danergva. .

2008 wlis aprilSi proeqtis menejeri saqarTvelos delegaciasTan erTad, romelsac xelmZRvanelobda saqarTvelos pirveli ledi, ewvia amerikis SeerTebul Statebs. vizitis mizani iyo SeerTebul StatebSi sarZeve jirkvlis kibos skriningis programebiT dagrovili gamocdilebis Seswavla

garda amisa, UNFPA wvlili Seaqvs sarZeve jirkvlis daavadebebis skriningisa da diagnostikis xarisxis uzrunvelyofis erovnuli gaidlainebis SemuSavebaSi. specialurma samuSao jgufma, romelic dakompleqtebulia qveynis wamyvani dawesebulebebis, maT Soris erovnuli skrining centris specialistebiT reproduqciuli janmrTelobis erovnul sabWosTan koordinaciaSi daadgina, rom zemoT aRniSnuli gaidlainebi unda SemuSavdes saukeTeso saerTaSoriso gamocdilebis safuZvelze. gaidlainebis saboloo versia daurigda adgilobriv eqspertebs Semdgomi ganxilvisaTvis. erovnuli gaidlainebi SemuSavda sarZeve jirkvlis kibos skriningisa da diagnostikis evropuli gaidlainebis meoTxe gamocemis safuZvelze.

samedicino informaciis kargad SemuSavebuli programa mniSvnelovan rols asrulebs skriningis programis efeqtur marTvasa da misi xarisxis gaumjobesebaSi. mosamzadebel etapze, orma frangulma kompaniam (OSI sante da feniqs SAS),

romlebTanac saqarTvelos mTavrobam gaaforma xelSekruleba, saqarTvelos mxares miawoda skriningis marTvis sainformacio sistemis programuli uzrunvelyofa “amazonisa” da “smarTmenejeris” CaTvliT. sistemis integrirebis koordinirebas axorcielebda adgilobrivi sainformacio kompiuteruli teqnologiebis jgufi, da aseve kompaniebi 2IM da GE, romlebic axorcielebdnen skriningis samedicino aRWurvilobis miwodebas. skriningis proeqtis farglebSi UNFPA udidesi wvlili

7


2008

Seitana skrininguli kvlevebis erovnuli centris skriningis marTvis sainformacio sistemis SemuSavebis saqmeSi. UNFPA moaxdina programis dawyebisaTvis saWiro IBM – is teqnikiTa da Microsoft – is programuli produqciiT uzrunvelyofa da daafinansa saonformacio – kompiuteruli teqnologiebis sferoSi aucilebeli kadrebi. saonformacio – kompiuteruli teqnologiebis infrastruqtura Seiqmna da misi mxardaWera xorcieldeboda saTanado gamocdilebisa da momzadebis mqone specialistebis mier. skriningis marTvis kompiuterulma sainformacio sistemam mniSvnelovnad Seamcira saqaRalde samuSaoebi, gazarda samuSaos siswrafe da uzrunvelyo drouli da zusti statistika. sainformacio centri Seiqmna UNFPA – is mier da miznad isaxavsASemomavali zarebis marTvasa da skriningis programaSi msurvelebis Caweras.

statistikuri da epidemiologiuri monacemebis Segrovebisa da analizis da im qalebis Semdgomi monitoringis mizniT, romlebmac Caitares skriningi, UNFPA proeqtSi samuSaod daiqirava eqimi epidemiologi.

3. reproduqciuli traqtis skriningisa da kibos kontrolis sferoSi samedicino momsaxurebis mimwodebelTa erovnuli simZlavreebis Seqmna

proeqtis farglebSi pirveladi jandacvis dawesebulebebis menejerebisaTvis Catarda erT dRiani mrgvali magida/seminari. seminaris miznebi iyo:

1. menejerebisaTvis detaluri informaciis miwodeba sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis programaSi pirveladi jandacvis rgolis CarTulobis didi mniSvnelobis Sesaxeb;

2. pirveladi jandacvis eqimebis Cabma sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis programis farTo sazogadoebisaTvis gacnobis procesSi.

seminaris monawileebma Sromis, janmrTelobisa da socialuri dacvis saministrosaTvis SeimuSaves rekomendaciebi, kerZod:

pirveladi jandacvis eqimebis momzadeba sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis programiT;

sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis Sesaxeb informaciis delegireba ojaxis eqimis movaleobebSi da pirveladi jandacvis federalur programaSi;

8


2008

specialuri sqemis SemuSaveba, raTa moxdes qalebis referireba skriningis programaSi;

pirveladi jandacvis eqimebis monawileoba im qalebis monitoringSi, romlebmac Caitares skrininguli kvleva.

15 dekembers Catarda wliuri konferencia “partnioroba sarZeve jirkvlisa da saSvilosnos yelis kibos prevenciisa da kontrolis uzrunvelsayofad”. masSi monawileoba miiRes yvela dainteresebulma mxarem da dargis yvela eqspertma: jandacvis ministrma, saqarTvelos pirvelma ledim – reproduqciuli janmrTelobis erovnuli sabWos Tavmjdomarem, saqarTvelos parlamentis orma vice spikerma, parlamentis jandacvisa da socialuri daxmarebis komitetis Tavmjdomarem, Tbilisis meriis socialuri daxmarebis da kulturis departamentis xelmZRvanelma, saerTaSoriso organizaciebis, samedicino asociaciebisa da samedicino dawesebulebebis warmomadgenlebma.

4. mosaxleobis qcevis Secvlaze orientirebuli saganmanaTlebo kampania

skriningis programaSi monawileobisaTvis qalTa mosaxleobis mozidvis erT-erTi meTodia media saSualebebis gamoyeneba da saganmanaTlebo kampaniebis Catareba. samedicino intervenciebis gamoyenebisadmi damokidebulebaze zemoqmedebis sferoSi arsebuli saerTaSoriso gamocdilebis safuZvelze skriningis warmodgenil programaSi gamoyenebul iqna iseTi meTodebi, rogoricaa masmedia, presa da sainformacio-sareklamo masalebis distribucia. am TvalsazrisiT proeqtis farglebSi ganxorcielda Semdegi RonisZiebebi: - skriningis programis dawyebidan

20 dRis ganmavlobaSi sazogadoebrivi televiziis arxiT gadioda specialuri mokle komerciuli rgoli

- cxovrebis jansaRi wesis stimulirebisa da sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis mniSvnelobis Sesaxeb mosaxleobis informirebis mizniT radio “mwvane talRaze” 6 Tvis manZilze sruldeboda 30 wamiani CarTvebi (4 sxvadasxva tipis); am TvalsazrisiT kavSiri damyarda UNFPA - is sxva proeqtTan - G“reproduqciuli janmrTelobis maRali xarisxis momsaxurebis uzrunvelyofasa da reproduqciuli janmrTelobis saxelmwifo politikis gaumjobesebaze mzardi moTxovnis mxardaWera”.

9


2008

- daibeWda da zogadad Tbilisis mosaxleobasa da qalTa mosaxleobis im nawilSi, romlebmac gaiares skriningi, gavrcelda kibos adreul etapze gamovlenis da sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis mniSvnelobis Sesaxeb broSuris 10 aTasi egzempliari. garda amisa daibeWda da gavrcelda 10 aTasi broSura sarZeve jirkvlis TviTgasinjvis Sesaxeb da 5 aTasi specialuri sareklamobukleti.

- skrininguli kvlevebis erovnuli centris da misi partniori

organizaciebis specialistebi monawileobdnen reproduqciuli janmrTelobisa da reproduqciuli traqtis kibos skriningisa da prevenciis mniSvnelobisadmi miZRvnil “Toq-SouebSi” da pasuxobdnen auditoriis kiTxvebs kibos adreul niSnebis, risk faqtorebis, daavadebis adreul etapze gamovlenis da mkurnalobis SesaZleblobebis Sesaxeb.

- reproduqciuli janmrTelobis, reproduqciuli traqtis kibos skriningis da prevenciis da sarZeve jirkvlis TviTgasinjvis Sesaxeb mokle filmebis Cvenebis mizniT skrininguli kvlevebis erovnuli centris foieSi damontaJebuli iqna didi satelevizio ekrani.

5. sarZeve jirkvlis da saSvilosnos yelis kibos skriningi da adreuli

gamovlena (saangariSo periodSi)

skriningis programis mizania sarZeve jirkvlis da saSvilosnos yelis kibos adreuli gamovlenis maCveneblebis maqsimalurad gazrda samizne mosaxleobaSi da kiboTi gamowveuli avadobisa da sikvdilianobis Semcireba. saangariSo periodSi (2008 wlis maisi – 2008 wlis 18 dekemberi) sul sarZeve jirkvlis kibos skriningi Cautarda Tbilisis da Tbilisis Semogarenis macxovrebel, 40 – 69 wlis asakobrivi jgufis 9741 qals, xolo saSvilosnos yelis kibos skriningi ki Tbilisis da Tbilisis Segarenis macxovrebel, 25 – 60 wlis asakobrivi jgufis 9010 qals (cxrili 6.1).

10


2008

SemTxvevaTa skriningis 50%-ze meti ganaxorciela skrininguli kvlevebis erovnulma centrma, xolo darCenili nawilisa ki kontraqtorma partniorebma maTdami daqvemdebarebul samkurnalo da diagnostikur centrebSi.

saangariSoperiodSi Catarebuli diagnostikuri procedurebi ganawilda Semdegi saxiT: 9741 qalidan, romelmac gaiara sarZeve jirkvlis kibos skriningi ultrabgeriTi gamokvleva Cautarda 2005 qals (21%), xolo citologiuri gamokvleva ki Catarda 307 SemTxvevaSi (3.2%); 9010 qalidan, visac Cautarda saSvilosnos yelis kibos skriningi, PAP kvleva Catarda 8124 (90%) SemTxvevaSi, xolo kolposkopiuri kvleva ki 510 (5,6%) SemTxvevaSi.

skriningis programis Sedegad 78 SemTxvevaSi gamovlinda sarZeve jirkvlis kibo an simsivnis avTvisebiani formis arsebobis maRali albaToba da 252 SemTxvevaSi - sarZeve jirkvlis simsivnis keTilTvisebiani forma. 78-idan 47 SemTxvevaSi avTvisebiani simsivnis arseboba dadginda citologiuri kvleviT, xolo danarCen SemTxvevebSi eWvi avTvisebian simsivneze warmoiSva BIRAD – is sistemis gamoyenebiTACatarebuli mamografiuli kvlevis safuZvelze. TiToeul qals, romlis mimarTac warmoiSva avTvisebiani simsivnis arsebobis eWvi, Cautarda detaluri konsultacia da mieca rCeva Semdgomi diagnostikisaTvis da/an Terapiuli/qirurgiuli mkurnalobisaTvis miemarTa specializirebuli klinikisaTvis. Semdgomi informacia yoveli pacientis mkurnalobis Sedegebis Sesaxeb Segrovebis procesSia da xelmisawvdomi iqneba 2009 wlis ianvris Sua ricxvebSi.

2008 wels Catarebuli 9010 PAP testidan 8157 (90%) SemTxveva normis farglebSi iyo, darCenili 852 testi kvalificirebuli iyo, rogorc anomaluri. Sedegebi ganawilda Semdegnairad: 384 (45%) SemTxvevaSi gamovlinda daudgeneli mniSvnelobis atipiuri ujredebi (ASCUS), 194 (22,7%) SemTxvevaSi adgili hqonda dabali xarisxis skvamozur intraepiTelialur dazianebebs (LSIL), 244 (28,6%) SemTxvevaSi – maRali xarisxis skvamozuri intraepiTelialuri dazianebebi (HSIL), 17 (2%) qals daudginda atipiuri skvamozuri ujredebis arseboba – ver gamovricxavT HSIL (ASC-H), 6 (0,7%) SemTxvevaSi gamovlinda dauzustebeli mniSvnelobis atipiuri jirkvlovani ujredebi (AGUS/AGC), xolo 8 (0,9%) SemTxvevaSi Sedegebi klasificirebuli iyo rogorc invaziuri kibo (cxrili 6.2.). PAP testis anomaluri Sedegebis mqone yvela qals eZleoda kolposkopiuri kvlevis Catarebis SesaZlebloba da mxolod im SemTxvevaSi Tu kolposkopiuri kvleva iZleoda uaryofiT Sedegebs maT eZleodaT rekomendacia 6 – 12 TveSi citologiuri kvlevisa da PAP testis ganmeorebiT Catarebaze. danarCen SemTxvevebSi saeWvo pacientebi gagzavnili iyvnen specializirebul samedicino dawesebulebebSi.

11


2008

cxrili 6.1 qalebis raodenoba, romlebsac saangariSo periodis ganmavlobaSi CautardaT skriningi (sarZeve jirkvlisa da saSvilosnos yelis skriningi)

maisi ivnisi ivlisi Aagv. seqt. Ooqt. Nnoem. Ddek. sul

saSvilosnos yelis skriningi

1061 1684 1312 1085 1246 928 1046 648 9010

skrininguli kvlevebis erovnuli centri N

440 749 633 639 727 532 571 336 4627

tatiSvilis samedicino centri

427 583 304 249 333 208 407 223 2734

Tbilisis onkologiis centri

194 352 375 197 186 188 168 89 1749

sarZeve jirkvlis skriningi

1221 1667 1500 1217 1237 1076 1190 633 9741

skrininguli kvlevebis erovnuli centri N r

571 754 745 813 723 592 545 326 5069

tatiSvilis samedicino centri

469 629 469 252 373 332 425 236 3185

Tbilisis onkologiis centri T

181 284 286 152 141 152 142 63 1401

RuduSauris sax samedicino centri

78 8 86

cxrili 6.2. saangariSo periodSi gamovlenili keTilTvisebiani da avTvisebiani simsivneebis SemTxvevebis raodenoba

sarZeve jirkvlis

avTvisebiani da avTvisebianze

saeWvo Semtxvevebi

keTilTvisebiani SemTxvevebi

78 252 saSvilosnos

yelis invaziuri

kiboI

ASCUS LSIL HSIL ASC-H

AGUS/AGC

8 384 194 244 17 6

12


2008

ZiriTadi xelisSemSleli da xelisSemwyobi faqtorebi

ZiriTadi xelisSemSleli faqtorebi

proeqti waawyda winaaRmdegobebs skriningis marTvis sainformacio sistemebis danergvis procesSi. skriningis marTvis sainformacio sistemebTan dakavSirebuli saorganizacio sakiTxebi ganxorcielda Sromis, janmrTelobisa da Socialuri dacvis saministros mier 2007 wels. sawyisi gegmiT gansazRvruli sakadro da finansuri resursebi arasakmarisi aRmoCnda sainformacio sistemis asamuSaveblad, ris Sedegadac moxda skriningis proeqtis teqnikuri moTxovnebis arasworad gansazRvra. aseve ar iyo gaTvaliswinebuli sainformacio teqnologiebis gadmocema da Semdgomi xelSewyoba. aseTma Seusabamobebma gamoiwvies sistemis ganviTarebisa da funqcionirebis TandaTanobiTi moSla. proeqtis ZiriTad xelisSemSlel pirobebs Seadgenda: qarTulenovani angariSebisa da programis interfeisebis ar arseboba, sistemis funqcionirebis arasakmarisi codna da arasakmarisi farTi diskebis Sesanaxad. sastemis wesrigSi mosayvanad safrangeTis mxarem warmoagzavna st specialisti, magram sistemis gamarTuli funqcionirebisaTvis jer kidev bevri ram darCa gasakeTebeli.

kidev erTi problema, romelic gamovlinda programis ganxorcielebis pirveli Tvis ganmavlobaSi mdgomareobda SemdegSi: imis gamo, rom sarZeve jirkvlis da saSvilosnos yelis skriningis programaze warmoiSva didi moTxovna da skrininguli kvlevebis erovnuli centris cxeli xazi/saregistracio ofisi, romelic dakompleqtebuli iyo ori operatoriT da maT movaleobas Seadgenda Semomaval zarebze pasuxis gacema da msurvelebis registrireba Semdgomi skriningisaTvis, veRar marTavda zarebis aseT did raodenobas, programas Seeqmna problemebi momxmareblebis moTxovnis dakmayofilebis TvalsazrisiT. ufro metic, rogorc amas Cveni momxmareblebi aRniSnavdnen, umetes SemTxvevaSi satelefono xazebis gadatvirTvis gamo isini ver axerxebdnen skrininguli kvlevebis centrTan dakavSirebas. es ki iwvevda saCivrebs momxmareblebis mxridan da programis efeqturad ganxorcielebis dagvianebas. amitom, satelefono zarebis da msurvelebis registrirebis efeqturi menejmentis mizniT moxda sainformacio centris organizeba. aman gazarda msurvelTa xelmisawvdomoba skrininguli kvlevebis centrisadmi.

programis ganxorcielebis ZiriaTad xelSemwyob faqtorebs, romlebmac wvlili Seitanes proeqtis warmatebaSi warmoadgenen:

o partnioruli urTierTobebi gaerosa da saqarTvelos mTavrobas Soris es erTaderTi proeqtia, romelSic saqarTvelos mTavroba UNFPA partniorobiT axorcielebs fondebis investirebas.

13


2008

o qselis Seqmna: proeqtis meSveobiT Seiqmna da gaZlierda qseli, romelSic

gaerTiandnen ara mxolod adgilobrivi da saerTaSoriso specialistebi, aramed saqarTvelos dedaqalaqSi da regionebSi momuSave profesionalebic;

o Sedegebze dafuZnebuli marTva da angariSgeba: proeqti warmoadgens

angariSgebis, efeqtianobisa da gamWvirvalobis karg magaliTs;

o UNFPA – is wvlili: finansuri mxardaWera da teqnikuri da samenejmento mxardaWera; proeqtis menejmenti xorcieldeboda UNFPA – politikisa da procedurebis gaTvaliswinebiT, rac dadebiTad aisaxa proeqtis Sesrulebis efeqtianobaze. proeqtisaTvis sargeblobis momtani iyo kavSirebi 2006-2010 wlebSi UNFPA – is qveynis programis egidiT mimdinare sxva proeqtebTan.

warmodgenili piloturi proeqti SeiZleba CaiTvalos warmatebul magaliTad, romelic SeiZleba dainergos saqarTvelos sxva didi qalaqebis municipalitetebis mier.

gaweuli samuSaos Seswavlis, monitoringisa da Sefasebis Sedegad miRebuli codna:

Tbilisis municipalitetisa da UNFPA – is mier sawyis etapzeve ganisazRvra da Camoyalibda samizne Sedegebi. samizne Sedegs warmoadgens im qalebis procentuli raodenoba, romlebsac ori wlis periodSi CautardaT skriningi sarZeve jirkvlis kiboze. TbilisSi cxovrobs 40-69 wlis asakis 214,905 qali, romelic ori wlis periodisaTvis warmoadgenen skriningis programis samizne mosaxleobas; maSasadame, sarZeve jirkvlis kibos skriningisaTvis erTi wlis intervalisaTvis samizne mosaxleobis raodenoba iqneba 107,452 qali. pirveli wlis mizani iyo skriningis Catareba mdedrobiTi sqesis samizne mosaxleobis 20%-isaTvis, xolo meore wlis ki skriningis Catareba samizne mosaxleobis 30%-isaTvis. programa daiwyo 2008 wlis maisSi da amave wlis dekembrisaTvis sarZeve jirkvlis skriningi Cautarda samizne mosaxleobis 14,1%-s. es maCvenebeli imaze maRalia vidre igegmeboda 8 Tvis periodisaTvis (12%) (cxrili 1).

14


2008

cxrili 1

indikatorebi samizne maCvenebeli

05/2008-12/2008

samizne maCvenebeli

2008

samizne maCvenebe

li

2009

Sedegi

samizne mosaxleobis saerTo

raodenoba 64 471 107 452 107 452

im qalTa procentuli

wili, romlebsac CautardaT skriningi

12% 20% 30% 14,1%

im qalTa saerTo raodenoba, romlebsac CautardaT skriningi

5372 21 490 32 235 9741


(skriningis

centri/pjd)

21490 / 0 22235 / 10000

igive samizneebi ganisazRvra saSvilosnos kibos skriningisaTvis. TbilisSi cxovrobs 25-60 wlis asakis 280,000 qali, romelic sami wlis periodisaTvis warmoadgenen saSvilosnos yelis skriningis programis samizne mosaxleobas; maSasadame, saSvilosnos yelis kibos skriningisaTvis erTi wlis manZilze samizne mosaxleobis raodenoba iqneba 93,333 qali. pirveli wlis mizani iyo skriningis Catareba mdedrobiTi sqesis samizne misaxleobis 20%-isaTvis, xolo meore wlis ki skriningis Catareba samizne mosaxleobis 30%-isaTvis. programa daiwyo 2008 wlis maisSi da amave wlis dekembrisaTvis saSvilosnos yelis kibos skriningi Cautarda samizne mosaxleobis 15%-s. es maCvenebeli imaze maRalia vidre igegmeboda 8 Tvis periodisaTvis (12%) (cxrili 2)

15


2008

cxrili 2

indikatorebi samizne maCvenebeli

05/2008-12/2008

samizne maCvenebeli

2008

samizne maCvenebe

li

2009

Sedegi

samizne mosaxleobis saerTo

raodenoba 62 222 93 333 93 333

im qalTa procentuli

wili, romlebsac CautardaT skriningi

12% 20% 30% 15%


7466 18666 27999 9010

skrininguli kvlevebis centri monitoringisa da Sefasebis da programis Sesrulebis xarisxis Sida kontrolis RonisZiebebis farglebSi sistematurad atarebs pacientebis kmayofilebis kvlevas, rac gamoixateba imaSi, rom randomizirebuli principiT SerCeul pacientebs sTxoven Seavson or gverdiani kiTxvari. kiTxvari sruliad anonimuria da masSi ar fiqsirdeba aranairi piradi informacia. kiTxvaris Sevsebis Semdeg furclebi unda davkecoT da CavagdoT specialur yuTSi. kiTxvari Seicavs formulirebebs, romlebic gansazRvraven pacientis kmayofilebas an ukmayofilebas. amasTan, masSi mocemulia kiTxvebi, romlebic saSualebas gvaZleven ganvsazRvroT informaciis wyaro, saidanac pacientma Seityo skriningis centris Sesaxeb (ix. danarTi 1). pasuxebis Sefaseba xdeba 1-idan 5-mde qulebiT, sadac 1 aRniSnavs srul Tanxmobas mocemul formulirebasTan., 3 miiCnevs amas bunebrivad, xolo 5 formulirebis srul miuReblobas. Sekrebili monacemebi sistematurad Sedis specialurad SemuSavebul monacemTa bazaSi Epi Info (versia 3.5.1) . aseve swarmoebs misi sistematuri analizi. cxrili 3 warmogidgenT pacientTa kmayofilebis mimdinare kvlevis winaswar Sedegebs. sul mocemuli momentisaTvis kiTxvari Seavso 170 pacientma.

16


2008

cxrili 3

mosazreba N Mean Mode Standard deviation

kmayofili var im samedicino gamokvleviT romelic me Cavitare

170 1,34 1 0,66

qalbatonebs didxans uwevs lodini servisis misaRebad

150 3,06 4 1,40

eqimebi Zalian megobruli da yuradRebiani arian

160 1,37 1 0,67

mogTxoves Tu ara raime Tanxa gamokvelevebis dros

164 1,30 1 0,66

centris TanamSromlebi Zalian zereled mepyrobian

157 4,54 5 0,71

sakmaod gamiWirda vizitis droulad daniSvna an telefoniT dakavSireba ris gamoc didi dro damakargines

161 4,19 5 1,04

me ukmayofilo var im samedicino momsaxurebiT romelic miviRe

153 4,11 5 1,17

samedicino dawesebiulebas sadac me gaviare skriningi, rekomendacias gavuwevdi Cemi ojaxis wevrebs, megobrebs

151 4,18 5 1,08

samedicino personalma girCiaT Tu ara konkretul samedicino dawesebulebaSi mkurnaloba

162 1,53 1 0,87

saWiroebis SemTxvevaSi isurvebdiT rom mkurnaloba gagegrZelebinaT imave dawesebulebaSi sadac CaitareT gamokvleva

129 3,09 4 1,51

srulad veTanxmebi-1; veTanxmebi –2; nawilobriv veTanxmebi-3; ar veTanxmebi-4; srulebiT ar veTanxmebi-5 zogadad pacientebi kmayofilebi arian miRebuli momsaxurebiT da personalis damokidebulebiT. savaraudoa, rom isini rekomendacias gauweven skriningis centrs maT naTesavebTan da megobrebTan. sainteresoa, rom maT surT mkurnaloba ganagrZon amave centrSi. ZiriTadad ukmayofilebis mizezs warmoadgenda momsaxurebis dagvianeba, rac miuTitebs skriningze moTxovnis zrdasa da sxva msgavsi centrebis araxelmisawvdomobaze. am mimarTebiT skrininguli kvlevebis erovnuli centri momaval wels didubeSi xsnis skriningis axal centrs. pacientebis umetesi nawili (daaxloebiT 75%) acxadebs, rom programis Sesaxeb Seityo televiziis meSveobiT.

17


2008

partnioroba

proeqti axorcielebs metad nayofier TanamSromlobas:

- saqarTvelos reproduqciuli janmrTelobis erovnul sabWosTan, romlis Tavmjdomarea saqarTvelos pirveli ledi. sabWom specialuri Sexvedra miuZRvna aRniSnul proeqts, sadac proeqtis menejerebs miecaT SesaZlebloba warmoedginaT proeqtis mimdinare saqmianoba. garda amisa, proeqtma Semoitana iniciativa reproduqciuli janmrTelobis sabWosTan koordinaciaSi sarZeve jirkvlis kibos skriningis gaidlainebis SemuSavebis Sesaxeb.

- vriJes universitetis samedicino centrTan (amsterdami, niderlandebi) da morfologTa asociaciasTan XXI sarZeve jirkvlisa da saSvilosnos yelis diagnostikis sferoSi adgilobrivi simZlavreebis Seqmnis TvalsazrisiT (citopaTologia, histopaTologia da molekuluri biologia saSvilosnos yelisa da sarZeve jirkvlis diagnostikaSi). - klemorferonis onkologiisa da radiologiis respublikur centrTan(lioni, safrangeTi) – zemoT aRniSnul centrSi momzadeba gaiara skrininguli kvlevebis erovnuli centris samma TanamSromelma (orma radiologma da erTma menejerma). - skrininguli kvlevebis erovnuli centris qvekontraqtor organizaciebtan, kerZod, Tbilisis onkologiis centrTan da tatiSvilis samedicino centrTan. programis farglebSi msurvelebis nawilis skrininguli kvleva Catarda aRniSnuli qvekontraqtori organizaciebis mier.

18


2008

IV. finansuri implementacia

proeqtis danergva da xarjva swarmoebda proeqtis damtkicebuli biujetis mixedviT. miwodebis maCvenebeli Seadgens 100%; finansuri implementaciis detalebisaTvis ixileT danarTi 2.

V. momavali samuSao gegma

o programaSi monawileobis misaRebad mowvevis Sesaxeb Setyobinebebis

sistemis pilotireba Tbilisis erT an or raionSi; o pirveladi jandacvis eqimebis momzadeba skriningis Sesaxeb

sakiTxebSi;

o skrininguli kvlevebis erovnuli centris veb-gverdis momzadeba; o sarZeve jirkvlis kibos skriningis gaidlainebis dasruleba da maTi

damtkiceba Sromis, janmrTelobisa da socialuri dacvis saministros mier;

o gamocdilebis gaziarebisa da saukeTeso magaliTebis Seswavlis mizniT mWidro kontaqtebis damyareba msgavs organizaciebTan da programebTan rogorc evrokavSiris qveynebSi, aseve mezobel qveynebSi (samxreT kavkasiaSi, Savi zRvis auzSi);

o profesiuli konferenciis organizeba sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis sakiTxebze Savi zRvis auzis qveynebisaTvis;

o damatebiTi finansuri resursebis mozidva

19


2008

danarTi 1

mosazreba srulad veTanxmebi

veTanxmebi miWirs pasuxi

ar veTanxm

ebi

sruliad ar

veTanxmebi

kmayofili var im samedicino gamokvleviT romelic me Cavitare

1 2 3 4 5

qalbatonebs didxans uwevs lodini servisis misaRebad

1 2 3 4 5

daniSnul Ddros CagitardaT Sesabamisi gamokvleva

1 2 3 4 5

eqimebi Zalian megobruli da yuradRebiani arian

1 2 3 4 5

mogTxoves Tu ara raime Tanxa gamokvelevebis dros (daakonkreteT romel kvlevaSi)

1 2 3 4 5

centris TanamSromlebi Zalian zereled mepyrobian

1 2 3 4 5

sakmaod gamiWirda vizitis droulad daniSvna an telefoniT dakavSireba ris gamoc didi dro damakargines

1 2 3 4 5

me ukmayofilo var im samedicino momsaxurebiT romelic miviRe

1 2 3 4 5

samedicino dawesebiulebas sadac me gaviare skriningi, rekomendacias gavuwevdi Cemi ojaxis wevrebs, megobrebs

1 2 3 4 5

samedicino personalma girCiaT Tu ara konkretul samedicino dawesebulebaSi mkurnaloba

1 2 3 4 5

saWiroebis SemTxvevaSi isurvebdiT rom mkurnaloba gagerZelebinaT imave dawesebulebaSi sadac CaitareT gamokvleva

1 2 3 4 5

rogor gaigeT skrininguli programis Sesaxeb televizia radio megobrebi presa sxva dabrundebiT Tu ara gegmiur gasinjvaze rogorc Tqven rekomendaciaSi aris mocemuli diax ara Tu Tqveni pasuxi uaryofiTia ganmarteT mizezi Tqveni mosazrebebi, rogor SeiZleba momsaxureobis gaumjobeseba, ras SecvlidiT? ______________________________________________________________________

20


2008

aRwera

sawyisi kontribucia UNFPA

F&A

proeqtis ganxorcielebisaTvis gaweuli xarjebi

balansi

(sul proeqtis biujeti)

UNFPA erovnuli

skrining centri

lari

aSS

dolari

aSS

dolari aSS dolari aSS dolari

aSS

dolari

saqarTvelos kontribucia

(fondis kodi: GEA03)

1-li tranSi, 2008w. 170,000.00 $118,055.56 $5,621.69

me-2 tranSi, 2008w. 200,000.00 $144,927.54 $6,901.31

me-3 tranSi. 2008w. 130,000.00 $93,525.18 $4,453.58

sul 500,000.00 $356,508.27 $16,976.58 $0.00 $340,134.04 -$602.35

2007 wlis naSTi gadmosuli

2008 wlis biujetSi $2,374.00

sul $2,374.00 $0.00 $1,506.39 $0.00 $867.61

UNFPA-s kontribucia (fondis kodi: FPA90)

sawyisi biujeti $80,000.00

damatebiTi Tanxebi $32,500.00

21


2008

sul $112,500.00 $0.00 $104,529.99 $7,966.36 $3.65

jami $471,382.27 $16,976.58 $106,036.38 $348,100.40 $268.91

22


2008

samuSao gegmis monitoringis meTodi

saangariSo periodi maisi 01 – dekemberi 17, 2008 weli

CP komponenti: reproduqciuli janmrTeloba rj donori organizacia: Tbilisis municipalitetTan arsebuli socialuri servisebisa da kulturis departamenti da gaeros mosaxleobis fondi; Semsrulebeli partniori: erovnuli skrining centri

mosalodneli CP

Sedegebi da indikatorebi, wliuri samizne

dagegmili RonisZiebebi

CmoTvaleT yvela RonisZieba,mat

xarjebi

CamoTvaleTRonisZiebebis

ganxorcielebis realuri

RonisZiebaTa ganxorcielebis

mdgomareoba

Sedegebis miRwevis progresi

wliuri samizne maCveneblebis gamoyenebiT

23


2008

Sedegebis CaTvliT

Soris monitoringisa da

Sefasebis RonisZiebebic

romelic orientirebulia dadgenili CP

Sedegebis miRwevaze

xarjebi. Sesrulebulia

nawilobriv

Sesrulebulia

ar aris Sesrulebuli

gansazRvreT progresis xarisxi Sedegebis miRwevis TvalsazrisiT. SesaZleblobis arsebobis SemTxvevaSi gaakeTeT komentarebiSedegebis miRwevis xelSemwyob da xelSemSlel faqtorebze, maT Soris:

xom araqv adgili an xom ar warmoqmnila CP

RonisZiebaTa gegmaSi da monitoringis meqanizmSi gansazRvruli riskebi da daSvebebi

Sida faqtorebi, rogoricaa Senatanebisa da RonisZiebebis droSi gansazRvra, servisebisa da produqtebis xarisxi, koordinacia da/an marTvis sxva sakiTxebi

gamosavali 1: gaizarda mosaxleobis xelmisawvdomobis reproduqciuli janmrTelobis yovlismomcveli momsaxurebisa da amomwuravi informaciisadmi

24


2008

Sedegi1.1:

: mosaxleobis, maT Soris axalgazrdebis xelmisawvdomobis gazrda reproduqciuli janmrtelobis yovlismomcveli, momxmarebelze orientirebuli momsaxurebisadmi jandacvis sistemis yvela doneze

indikatori 1.1.1

pirveli wlis samizne maCvenebliT: 2008

wlis bolosaTTvis sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis programaSi monawile samizne asaki qalebis maCvenebeli

wlis samizne maCvenebeli: ara nakleb 20% monawileoba

RonisZieba 01

TbilisSi sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis CatarebaUNFPA

mxardaWeriT

USD $ 112.500

X

o – proeqtis menejmentis mier SemuSavebuli monitoringisa da Sefasebis meqanizmi gviCvenebs, rom proeqti

warmoadgens angariSgebis, efeqtianobisa da gamWvirvalobis karg magaliTs;

- saangariSo periodSi(maisi 2008

dekemberi 18, 2008) sul sarZeve jirkvlis kibos skriningi Cautarda Tbilisis da Tbilisis Semogarenis macxovrebel, 40 – 69 wlis asakobrivi jgufis 9741 qals, xolo saSvilosnos yelis kibos skriningi ki Tbilisis da Tbilisis Segarenis macxovrebel, 25 – 60 wlis asakobrivi jgufis 9010 qals. skriningis programis Sedegad 78 wals gamouvlinda sarZeve jirkvlis avTvisebiani simsivne, an misi arsebobis maRali albaToba, xolo 252 SemTxvevaSi moxda keTilTvisebiani simsivneebis gamovlena. .

- 2008 wels Catarebuli 9010 PAP testidan, 8157 (90,5%) Sefasda rogorc normaluri, 852 testi rogorc anomaluri, xolo 8

25


2008

indikatori 1.1. 2. wlis samizne maCvenebliT: dabeWdili sainformacio/saganmanaTlebi/sakomunikacio masalebis raodenoba

wlis samizne maCvenebeli :

5,000cali dabeWdili sainformacio/saganmanaTlebi/sakomuni

RonisZieba 02

TbilisSi sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis Catareba

municipalitetis

mxardaWeriT

USD $ 358 882,27

X

SemTxvevaSi dadginda invaziuri kibo.

- pirveli wlis mizani iyo skriningis Catareba mdedrobiTi sqesis samizne mosaxleobis 20%-isaTvis. skriningis

programa daiwyo 2008 wlis maisSi da amave wlis dekembrisaTvis sarZeve jirkvlis skriningi Cautarda samizne mosaxleobis 14,1%-s. es maCvenebeli imaze maRalia vidre igegmeboda 7 Tvis periodisaTvis (12%). igive samizneebi ganisazRvra

EBA X01

swavleba: sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis dakontrolis adgilobrivi simZlavreebis Seqmna

USD $ 26 000

X

26


2008

kacio masala

indikatori 1.1.3

wlis samizne maCvenebliT:rt kibos skriningsa da prevenciaSi momzadebuli jadacvis mimwodeblebis raodenoba

wlis samizne maCvenebeli : rt kibos skriningsa da prevenciaSi momzadebulia jadacvis

70 mimwodebeli

saSvilosnos kibos skriningisaTvis. pirveli wlis mizani iyo skriningis Catareba mdedrobiTi sqesis samizne misaxleobis 20%-isaTvis,. programa daiwyo 2008 wlis maisSi da amave wlis dekembrisaTvis saSvilosnos yelis kibos skriningi Cautarda samizne mosaxleobis 15%-s. es maCvenebeli imaze maRalia vidre igegmeboda (12%). i - proeqtis farglebSi pirveladi jandacvis dawesebulebebis menejerebisaTvis Catarda erT dRiani mrgvali magida/seminari. - skriningis programis dawyebidan 20 dRis ganmavlobaSi sazogadoebrivi televiziis arxiT gadioda komerciuli rgoli sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis mniSvnelobis Sesaxeb - daibeWda da zogadad Tbilisis mosaxleobasa da qalTa mosaxleobis im nawilSi, romlebmac gaiares skriningi, gavrcelda kibos adreul etapze gamovlenis da sarZeve jirkvlisa da saSvilosnos yelis kibos skriningis mniSvnelobis Sesaxeb broSuris 10 aTasi egzempliari. garda amisa daibeWda da gavrcelda 10 aTasi broSura sarZeve jirkvlis TviTgasinjvis Sesaxeb da 5 aTasi specialuri sareklamo bukleti.

27


2008

-

ZuZusa da saSvilosnos yelis kibos skriningis programagnsc.ge/upload/files/2008.pdf · ZuZusa da...

Documents

Transcript of ZuZusa da saSvilosnos yelis kibos skriningis programagnsc.ge/upload/files/2008.pdf · ZuZusa da...