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  Possible Causes Suggested Solutions
Is there any problem in patient tracing and contact at PHI/ private hospital level?
  • Contact information not available in Ni-kshay
  • Incorrect address
  • No contact number
  • Assign one Drug-resistant TB (DR-TB) coordinator for the patient and entrust him for the follow-up.
  • Ensure correct data entry in Ni-kshay. Double check the address with id at Ni-kshay entry. Proper training and capacity building of the staff for the same.
  • Procure more than one contact number.
  • Seek the help of a Local Self Government (LSG) representative.
  • If the patient has moved out of the area, take measures to trace and transfer out to the respective area.
Patient resistance
  • Fear
  • Apprehension
  • Lack of family support 
  • No bystanders
  • Proper counselling of the patient and the immediate relative at the time of disclosure of the result is very important.
  • Counselling should be provided at each stage.
  • An immediate relative can be counselled and trained to be a treatment supporter of the patient. 
  • Seek cooperation from Non-government Organisations (NGOs)/ volunteers.
Is there any issue in pretreatment evaluation?
  • Distance to the testing facility
  • Cost of evaluation
  • Multiple visits needed
  • Delay in getting the reports
  • Transportation issues
  • Arrange for patient-centric quality services at a government facility to avoid patient discomfort.
  • Outsource in a partnership model in areas where facilities are not available. 
  • Arrange for transportation or refund of travel expenses.
Is there a delay in the initiation of treatment?
  • Patient resistance
  • Delay in results of pretreatment evaluation
  • Distance from the treatment centre
  • Counselling 
  • Fast-tracking the report
  • OPD-based treatment
  • Setting up a decentralized treatment facility
  • Arranging for transportation or reimbursement for travel
Do the patients from the private sector have issues in starting treatment?
  • Patient wants to continue the clinical services from the private provider, but drugs are not available.
  • Patient wants to change the treatment to a public health facility.
  • Coordinate with the hospital management and provide the drugs and necessary support.
  • Linkage through Public Private Partnership (PPP) 
  • Arrange for the patient transfer to a public health facility.
Other causes
  • Duplication of data entry leading to an inflated denominator (total diagnosed cases)
  • Issues with data entry in Ni-kshay
  • Proper monitoring to avoid duplication 
  • Training, monitoring of staff
  • Sort out internet connectivity issues

 

 

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Assessment

Question Option1 Option 2 Option 3 Option 4 Correct answer Explanation Page id Pretest Post-test
Which of the following does not minimise the delay in treatment initiation/ treatment not initiated for MDR-TB cases? Timely tracing of the patient Proper counselling of the patient A trained treatment provider  Not offering drugs to private patients  4 Timely tracing of the patient. proper counselling of the patient, a trained treatment provider will help minimise the delay in treatment initiation.      
LMS Page Link
https://cms.swasth-egurukul.in/en/page-preview/73480

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