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NTEP By Rajesh Das.pptx

  1. Rajesh Das BLOCKPUBLICHEALTHMANAGER CHANDIPUR BPHU,ERASHAL RURAL HOSPITAL CHANDIPUR,PURBA MEDINIPUR,WEST BENGAL National Tuberculosis Elimination Programme NTEP "টিবি মুক্ত িাাংলা তথা টিবি মুক্ত নন্দীগ্রাম স্বাস্থ্য জেলা-২০২৫“ টিবি মুক্ত চণ্ডীপুর BPHU-২০২৫
  2. What is Tuberculosis? Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis (MTB) which generally affects the lungs, but can also affect other parts of the body One patient with infectious pulmonary TB if untreated can infect 10-15 persons in a year. o Malnutrition o Diabetes o HIV infection o Poor immunity o Severe kidney disease o Other lung diseases like silicosis. o Substance abuse etc. o Overcrowding o Inadequate ventilation o Enclosed living/ working conditions o Occupational risks Risk factors:
  3. Showing that 3 TB Notification under NTEP
  4. Vision: A world free of TB Zero TB deaths, Zero TB disease, and Zero TB suffering Goal: End the Global TB Epidemic (<10 cases per 100,000 population) Sustainable Development Goals (SDG) INDICATORS TARGETS SDG 2030 Reduction in number of TB deaths compared with 2015 (%) 90% Reduction in TB incidence (new case) rate compared with 2015 (%) 80% TB-affected families facing catastrophic expenditures due to TB (%) Zero
  5. TB Free India • India has committed to End TB by 2025, 5 years ahead of the global SDG target • Prime Minister of India launched TB Free India campaign at ‘Delhi End TB Summit’ on 13th March, 2018 • The campaign calls for a social movement focused on patient-centric and holistic care driven by integrated actions for TB Free India
  6. More & more States committing to Ending TB Chhattisgarh Tamil Nadu State level commitment 14 State/UT Himachal Pradesh Kerala Lakshadweep Jharkhand 2020- Kerala 2021- Himachal Pradesh 2022- Gujarat, Lakshadweep & Sikkim 2025- Bihar,Chhatisgarh, Daman & Diu and Dadra & Nagar Haveli, Jammu & Kashmir,Jharkhand, Madhya Pradesh, Puducherry,Tamil Nadu and Andaman & Nicobar Islands
  7. 7 Strategies Private sector engagement Active Case Finding TB Co- morbidities Multi- sectoral response Drug Resistant TB ICT Tools for adherence and monitoring Preventive Measures Community Engagement National Strategic Plan (2017-25)
  8. Organizational structure Supporting Facilities  National Reference Laboratories (6)  Intermediate Reference Laboratories (31)  Culture and DST Laboratories (81 including IRL/NRL)  CBNAAT Laboratories (1268)  DRTB Centres- 703
  9. Key Services 1. Free diagnosis and treatment for TB patient 2. Public health action- contact tracing, testing for co-morbidities etc. 3. Treatment adherence support 4. Nutrition assistance to TB patients (DBT- Nikshay Poshan Yojana) 5. Preventive measures
  10. Strengthening Case Finding in the Public Sector Chest X Ray: Clinically diagnosed TB increased from 8.8 lakhs in 2017 to 12.7 lakhs in 2019 Revised Diagnostic Algorithm for TB: Increase in DR-TB cases from 38,000 in 2017 to 66,000 in 2019 Upfront Rapid Molecular Testing: Increased from 5.23 lakhs upfront tests in 2017 (16% yield) to 11.34 lakhs in 2019 (17% yield) Intensive Case Finding in Health facilities- Screening for TB among: -DM patients increased from 11.5 L in 2018 to ~20 L in 2019 - ICTC/ART referrals increased from 3.35 L in 2017 to 3.94 L in 2019 Active Case Finding in vulnerable population: from 5.5 crore population screened in 2017 to 28 crores screened in 2019. Yield increasing from ~27,000 to ~63,000 TB patients. Leveraging Outreach of other Healthcare Programmes: 8.3 lakhs referrals from Health & Wellness Centres . PASSIVE APPROACH TO CASE FINDING ACTIVE APPROACH TO CASE FINDING
  11. Treat Treatment Patient Centric Care Reduce Out-of-pocket Expenditure • Daily Regimen • Shorter Regimen • Newer Drugs • IT Enabled Adherence Support • Comorbidity management • Financial incentives • Direct Benefit Transfer
  12. Direct Benefit Transfer (DBT) schemes 1. Honorarium to Treatment Supporters – For provision of treatment support to TB patients (Adherence, ADR monitoring, counselling @Rs.1000/- to Rs.5000/-) 2. Patient Support to Tribal TB Patients (Financial Patient Support @Rs750/-) 3. Nutritional Support to All TB patients (Financial Support to Patients @Rs.500/-month) 4. Incentives to Private Providers (Rs.500/- for Notification & Rs.500/- for reporting of Treatment Outcome 5. Incentives to Informant (Rs. 500/- is given on diagnosis of TB among referrals from community to public sector health facility)
  13. Prevent • Air borne infection control measures • Strengthen Contact Investigation • Preventive treatment in high risk groups • Manage Latent TB Infection • Address determinants of disease
  14. Multi-sectoral Engagement TB care services in health infrastructure Socio-economic support & Empowerment Infection Prevention Address Determinants Information Education Communication Prevention and Care at Work Place Corporate Social Responsibility TB - A social problem & needs multi-sectoral approach
  15. Inter-Ministerial Coordination AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) •1st meeting of National Technical Expert Group on NTEP-AYUSH Collaboration & e-consultation of experts held •2nd draft of Policy Document and Joint Letter drafted Railways •Joint Working Group to be formed to monitor implementation Defence •Action Plan developed. •95 Ex- Servicemen Contributory Health Scheme (ECHS) Polyclinics registered in Nikshay, remaining underway Labour and Employment • MoU signed in September 2020
  16. Community Engagement Transformation of TB survivors to TB champions Capacity building and mentoring programme Engagement of existing community groups like PRI, SHG, VHSNC, MAS, Youth Club Grievance redressal mechanism Involvement of community representatives in different forums TB Forums at the National, State and District level to provide a platform for all stakeholders, including the community, to voice their views
  17. Call Centre- Nikshay Sampark  1800-11-6666  Outbound & Inbound  Time – 7 to 11  Languages – 14  100 call centre agents  Pan-India coverage  Citizen – Patient - Providers • Counselling • Treatment Adherence •Grieva nce Redres sal • Follow Up • TB Notification • Information Policy Update in RNTCP, 2018
  18. State TB Index Policy Update in RNTCP, 2018
  19. 1. Under reporting and uncertain care of TB patients in private sector 2. Reaching the unreached – Slums, Tribal, vulnerable 3. Drug Resistant TB 4. Co-morbidities – HIV, Diabetes 5. Undernutrition, overcrowding 6. Lack of awareness and poor health seeking behaviour lead to delay in diagnosis Key Challenges
  20. Key Take Away • Improve TB notification rate Ensure mandatory TB notification from private sector • Active TB Case Finding to reach the unreached • Optimum utilization of CBNAAT machines • Expand Universal Drug Susceptibility Testing coverage • NIKSHAY Poshan Yojana to every TB patients • 100% reporting through NIKSHAY • Collaboration with Line Ministries to tackle social determinants of TB • Community participation for TB Elimination
  21. Thank You Bending the Curve Accelerating towards a TB free India

Notes de l'éditeur

  1. 1.89 lakhs in 2019- tb through naat upfront 2018-3.35 lakhs referrals from ART
  2. In RNTCP, one of the first health programs to move to DBT, will be using it to transfer monetary benefits to eligible patients and providers. We would be using Nikshay to identify the beneficiaries and the transfer of funds will be through the Public Financial Management System or PFMS