Competencies of the Health Volunteer

The following nine competencies are important to a health volunteer -

Sr No	Competency	Description/ activities pertaining to the said competency	Assessment of competency
1	Talk about TB	Provide correct information about TB to anybody that (a) It is curable, (b)symptoms of TB, (c) Diagnostic services available in the health facilities, (d) Prevention of TB (Ventilation, Cough etiquette, TB Preventive Therapy)	1. Observe the health volunteers talking about TB during home visits
2	Screen for TB using the 4 symptom complex	Identify individuals with high vulnerability to develop TB/TB Infection. Screen them using 4 symptom complex and identify "presumptive TB."  Identify individuals eligible for TB Preventive Therapy/ testing for TB Infection	1. Observe a health volunteer screening for TB during home visits
3	Refer for diagnosis to the nearest TB Testing Centre.	Counsel the people with presumptive TB/ eligible for TBI testing to visit the nearest health facility. Refer presumptive TB/those eligible to be tested for TBI to the nearest health facility. Document the same in Ni-kshay using the Treatment Supporter login credentials	1. Observe a referral process during the home visit, including recording of the information in Ni-kshay
4	Collect the sample from a presumptive TB and transport it to the testing facility	Educate the eligible regarding how to collect good quality sputum. While following Infection Prevention & Control measures, collect the samples, label and transport it.	1. Check with the laboratory regarding the quality of samples collected by the health volunteer
5	Provide Treatment adherence Support for TB Treatment and TPT*	Provide treatment adherence support to the persons affected with TB/ people taking TPT. Document the adherence in Ni-kshay using treatment supporter login credentials	1.  Review Ni-kshay / Treatment cards for Adherence scores of presently linked patients 2. Interview patients to check the kind of support they received
6	Counsel people who are on TB treatment/TPT and their family*	Counsel people on treatment for TB/ preventive treatment regarding (a) treatment adherence,(b) nutrition, (c) ADR, (d)addressing stigma, (e) infection control measures, f) social welfare measures	1. Interview with health volunteers to  understand the current practice.
7	Detect Adverse Drug Reactions and Refer them for timely for management*	Detect common ADRs among the people taking anti-TB treatment/ TPT. Refer them timely to a health facility for management of ADR	1. interview the linked patients regarding how ADR was managed for them.
8	Perform post-treatment follow-up*	Follow up the people who completed TB treatment/TPT every six months and screen them for TB disease	1. Check whether previously linked Treatment completed patients have all their post treatment follow up due completed.
9	Use Ni-kshay for performing the actions related to the above	Using Ni-kshay, screen, refer for testing, collect and dispatch samples, record and monitor treatment adherence, record ADR, view DBT statuses	Check ability to login, enrol and refer patients to health facilities, sample collection and transportation and also mark treatment adherence in Ni-kshay during patient visit.

The five (first four and last one) are core competencies of all volunteers while the remaining four (marked with *) are core competencies only if the volunteer acts/ intends to act as a treatment supporter.

The knowledge and training related to these competencies will be provided through the Course for Health Volunteers on NTEP and assessed through the pre and post-test assessments/ quizzes.

Competency assessment needs to be done periodically (once in two years) or at the time of registration or initiation of the treatment regimen.