Introduction

State Tuberculosis Training & Demonstration Centers (STDCs) are state-level strategic institutions in the National Tuberculosis Elimination Programme (NTEP). Headed by an STDC Director, it acts as the knowledge hub in the state in relation to the TB program in the state. It supports the state in Program Management by conducting its core activities of Supervision, Monitoring and Evaluation (SM&E ) and Training in TB and NTEP. Apart from this it also performs some technical activities, such as, support in preparing the NTEP State PIP, implementation and scaleup of newer interventions, surveillance and TB Burden estimation, ensure quality assured laboratory services, conducting Operational Research, evolve the state Strategic Plan for TB Elimination and advocacy for TB Elimination efforts in the state.

STDCs were originally established during the National TB Program (NTP), that existed before 1998, as the Tuberculosis Demonstration and Training Centres (TDTCs). It was later redesignated as the STDCs (State Tuberculosis Demonstration and Training Centres) when Revised National Tuberculosis Control Programme (RNTCP) was launched. The Terms of Reference of an STDC was last formally released in 2004. It included Training, SM&E (Supervision Monitoring and Evaluation), External Quality assurance(EQA) of sputum microscopy, Advocacy, Communication, Social Mobilisation (ACSM), and Operational research (OR) as the major activities.

With the drive to accelerate progress toward TB Elimination, the NTEP has evolved and considerably expanded the range of TB services. The National Strategic Plan (NSP) of the NTEP envisaged the STDCs playing a significant role in building capacities of the NTEP cadres, General Health System, and Private health facilities/ providers, along with supervision, monitoring, evaluation of the programme and operations research. With the evolution of the TB program, the functions of STDCs have also expanded. Thus, there was a felt need to revisit the Terms of Reference. 

An STDC baseline assessment was conducted (April 2021-22), through the USAID supported iDEFEAT TB Project, to evaluate and document the current status and functioning of STDCs. It was observed that there was wide variation in the capacity and functionality of STDCs in the country. There was a need to focus on setting up a benchmark by revising the functional framework for STDCs. 

With this context, this revision of the STDC Guidelines seeks to formally update the previous Terms of Reference (2003) to match current program operations and vision of Ending TB. Using the guideline, states NTEP administrators should try to align their STDC structure and functions and eventually bring uniformity in its minimum functions and performance across the country. It will also enable the NTEP leadership to evaluate the functioning of these strategic institutions and build capacity and strengthen them for optimal functioning.