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Root Cause Analysis [RCA] for Low Performance in Percentage of Target TB Notification Achieved
Learning ObjectivesRoot cause analysis for Low Performance in Percentage of Target TB Notification Achieved
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Root Cause Analysis of Low Performance in Percentage of Target TB Notification Achieved
Low performance means notification of TB cases is not happening as desired.
Data is available in Ni-kshay and analysed in terms of:
- Whether the notification is less from a geographical area? (Peripheral Health Institute (PHI)/ TB Unit (TU), private hospital) - Place Analysis
- e.g., less notification from a particular PHI may be due to a newly recruited Medical Officer (MO) who is not trained in National TB Elimination Programme (NTEP). The solution should aim at training the MO to improve the notification from that PHI.
- Whether the notification is less in special age group/ gender/ population group?- Person Analysis
- e.g., teen-aged female patients due to attached stigma. Identification of the stigma by such analysis might be helpful in planning stigma reduction campaigns/ Advocacy, Communication and Social Mobilisation (ACSM) activities to enhance notification.
- Whether there is a change in notification trends across months? - Time Analysis
- e.g., festive season and marriage season might have less notification, as many patients neglect cough or chronic ill-health. However, this might be dangerous as the probability of spread during such festivals and marriage functions is quite high. Such analysis gives insights for enhanced active case finding during these seasons.
The notification depends on the presumptive TB examination rate. Look at the trends of presumptive examination rate. The expected is about 1500/ lac population.
Some of the reasons and suggested solutions for decreased TB notification are listed below.
Domains | Possible Problems | Suggested Solutions |
Patient |
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PHI |
Is the poor referral for testing due to:
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Private Hospital |
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Testing and Diagnosis |
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Notification
|
Not entering the data to Ni-kshay due to:
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Other causes |
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Resources
- India TB Report, CTD, MoHFW, GOI, 2022.
- Training Modules (5-9) For Programme Managers & Medical Officers, NTEP, CTD, MoHFW, GoI, 2020.
- National Strategic Plan for Tuberculosis Elimination 2017–2025, NTEP, CTD, MoHFW, GoI, 2017.
Assessment
Question | Option 1 | Option 2 | Option 3 | Option 4 | Correct answer | Explanation | Page id | Pretest | Post-test |
Which of the following is an exception to the steps for improving performance in target TB notification? | Increasing the number of presumptive TB cases examined | By active case finding | By improving diagnostic facilities | By initiating TB treatment | 4 | Treatment initiation is done after the notification process. |
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