As an initiative to strengthen STDCs and enable them to perform their functions with better efficiency, virtual knowledge hubs like ECHO hubs have been established at STDCs. STDCs need to use the virtual hubs for improvement of program efficiency and build the workforce capacity. Guidance for STDCs to design their virtual capacity building Program and effectively utilise virtual knowledge hubs are as follows.

Virtual capacity building programs by STDCs

The knowledge hubs should be widely used by STDCs as a cross learning platform and for mentoring the health workforce at the periphery during the regular capacity building and programmatic reviews. Following are some of the ways it could be used.

1. Training & Capacity Building

STDC is responsible for ensuring that the entire health system workforce is completely trained for optimally delivering NTEP services and each person has the capacity to execute their roles. STDCs could use knowledge hubs for training & capacity building in the following ways

1. Regular training: STDCs lead the planning and implementation of regular and routine cadre based training at all levels in the state for all healthcare staff working in the fight against TB in the state. This includes health system (govt or private), partners (NGOs, partner agencies etc) and other sectors. STDCs should effectively utilise Knowledge hubs for delivering the e- training courses for all cadres of including induction/ refresher/ update trainings. They need to prepare an annual training plan and decide which all courses could be scheduled as blended/ e- training through ECHO platform. How such trainings could be conducted will be detailed in the training operations guidance under modernized training strategy under NTEP.
2. Thematic Trainings: STDCs shall organise thematic trainings as and when there is a new program or when there is an update of the guideline/policy or based on the local needs, or as directed by CTD such as PMTPT, PMDT, Trainings for Sub-National Certifications, Trainings on Partnership Guidelines, Trainings on new features in Nikshay. STDCs shall identify the need and decide which all courses could be scheduled as e- training through the vitual platform.
3. Dissemination of ongoing program Updates: STDCs could plan regular or need based academic sessions at a fixed frequency for a specific target audience. This could be planned and designed based on local need. All such sessions need to be didactic with active involvement from the spoke institutions. For example, STDCs could plan a one-hour session for all TU level staff on every fourth Friday regarding TB and NTEP updates.
4. Special advanced courses for building capacity of health workforce/managers/administrators: STDCs could design and implement special courses beyond the routine/ regular training based on felt need of the State, for improving the efficiencies of the health or non-health workforce as an ECHO program. For example, a course on soft skills or communication or leadership or management or operations research or financial management could be imparted to selected cadre of staff through ECHO.
5. Continuing Medical Education: STDCs could plan CMEs on TB at fixed frequency for a specific target audience. STDCs could collaborate with STF or professional associations for such programs. For example, session for all post graduates and interns of medical colleges in collaboration with STF or session for general practitioners in collaboration with professional associations on every 2^nd Tuesday. Topics for such sessions could be decided based on local needs.
6. Case studies / Best Practices/ Cross learning Platforms: STDCs could also arrange a platform for facilitating experience sharing regarding success stories from field. Success stories could be any best practices or local solution to particular problems documented with some learning experiences. For examples DTOs can present about a case study about how they maintained case finding during COVID-19 pandemic period or how they engaged all sectors for TB or how they solved the issue of poor coverage of TPT among PLHIV. Such programs could be conducted regularly on fixed days such as every second Wednesday 12 noon.

2. Programmatic Reviews and Supportive supervision

Programmatic reviews directed towards identifying problems and their solutions are an excellent opportunity for mentoring and improving capacity of district level and sub- district level staff. Data available through Nikshay reports and Nikshay dashboards and all other sources may be analysed as prior preparation for the review and focused problem/ case-based approach may be used. These reviews need to be led and moderated by the STDC under the leadership of the STC.

1. Periodic Reviews: These include monthly, quarterly, half yearly and annual review for the districts and other sub-levels organized by the STDC in consultation with STC.  These reviews could be directed internally within the NTEP, or could be in collaboration with other programs such as NACO for cross learning and problem solving.
2. Need based Thematic reviews: STDCs should conduct thematic reviews on periodically or based local needs. Such reviews will be focussing on one particular theme of the program and will aim at building capacity of staff at field and solve problems at the field. These include reviews on PMTPT, PMDT, DBT, UDST, Private sector engagement, Paediatric TB Notification, Partnerships for TB Elimination, Finance, ACSM, Contact Tracing and so on.
3. Virtual Supportive Supervision: STDC may use the ECHO platform to conduct the supportive supervision activities aiming at handholding and mentoring of the staff at periphery in a virtual/ remote fashion. This includes virtual facility visit, physical examination of documents/ registers etc. 
4. Ad hoc capacity building

In order to ensure that complex problems are solved timely, the ad-hoc meetings and reviews play an important role. It ensures timely actions for improving a specific indicator or improvement of program of a particular district, institutions or staffs. 

1. Annual Planning of Hub activities

Based on the above types of each of the above three types of activities the STDCs may plan an annual calendar of virtual ECHO events.