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PMDT structure and roles
Learning ObjectivesPMDT structure and roles
The National TB Elimination Programme (NTEP) in India has established well-organised Drug-resistant TB (DR-TB) management structures at the national, state and district level.
Figure: Diagrammatic representation of the organisational structure of Programmatic Management of DR-TB (PMDT)
Abbr: NDR-TB: Nodal Drug-resistant TB; NAAT: Nucleic Acid Amplification Test; LPA: Line Probe Assay; CDST: Culture and Drug Sensitivity Test; DDR-TB: District DR-TB
The organisational structure and functions at different levels are described in the table below.
Level | Organisational Structure | Type of Organisation | Function |
National-level | Central TB Division (CTD), Ministry of Health and Family Welfare (MoHFW), Government of India (GoI) | Administrative | Providing resources/ devising policies/ issuing guidelines/ monitoring and evaluation/overall administration of the programme |
National Technical Expert Group | Advisory | Reviewing evidence Recommendation in guidelines | |
National Reference Laboratory (NRL) | Operational | Providing laboratory-related expertise, External Quality Assurance (EQA) guidelines, Accreditations, a centre of excellence in diagnostics | |
State-level | State TB Cell, Health Department | Administrative | Providing resources, implementing guidelines, monitoring and evaluation/ overall administration of the programme |
State PMDT Committee | Advisory | Overseeing implementation as per guideline, taking strategic decisions, reviewing the progress in implementation and feedback/ suggestion to NTEP | |
Nodal DR-TB Committee | Advisory | Guiding treatment of difficult to treat DR-TB cases, reviewing the progress of treatment and Adverse Drug Reaction (ADR) management, providing technical expertise for decisions at the State PMDT Committee, etc. | |
Intermediate Reference Laboratory (IRL) | Operational | Providing laboratory-related services and expertise at the State level, EQA, and capacity building for diagnostic services | |
Nodal DR-TB Centres | Operational | Providing treatment services to difficult-to-treat DR-TB cases, a centre of excellence in DR-TB treatment | |
District-level | District TB Cell | Administrative | Providing resources, implementing guidelines, monitoring and evaluation/ overall administration of the programme |
District TB Forum | Advisory | Overseeing implementation as per guideline, reviewing the progress in implementation, facilitating and monitoring the involvement of communities | |
District Comorbidity Committee | Advisory | Review and rectify TB-comorbidity components with regard to HIV, diabetes, addiction and other review coordination with other health programmes like Rashtriya Bal Swasthya Karyakram (RBSK), Rashtriya Kishorethe Swasthya Karyakram (RKSK), Reproductive Maternal Newborn Child plus Adolescent Health (RMNCH+A) etc. | |
District DR-TB Committee | Advisory | Guiding treatment of DR-TB cases, reviewing progress of treatment and ADR management, etc. | |
NAAT/ LPA/ CDST Laboratories | Operational | Providing diagnostic services to detect DR-TB in the district (at more than one district) | |
District DR-TB Centre | Operational | Providing treatment services to DR TB cases, ADR management etc. | |
DR-TB services integration into the general health system |
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Block-level/ Ward-level | Block Medical Officer/ Medical officer in office | Operational | Implementation of guidelines/ monitoring and evaluation of feedback |
Health facility-level | Health facility doctor, Master in Public Health Skills (MPHS), Multipurpose Health Worker (MPHW), Accredited Social Health Activist (ASHA) | Operational | Implementation and review |
Health & Wellness Centre, Sub-Centre | Community Health Officer (CHO) | Operational | TB screening and community intervention, coordination amongst various health programmes for TB-related activities |
Community | ASHA, Panchayati Raj Institutions (PRI), Anganwadi Workers (AWW), other volunteers and community leaders | Operational | Implementation , community engagement through PRI, Village Health and Nutrition Day (VHND) , Community meetings, peer educators/TB champions/adolescent groups and Anganwadi sessions |
The organisational structure based on functional roles can be classified into diagnosis, treatment and drugs.
Diagnosis:
Name of Facility |
Functions |
Health Facility |
|
NAAT Site |
|
C&DST Lab |
|
Treatment:
Name of Facility |
Functions |
Health Facility |
|
District DR-TB Centre |
|
Nodal DR-TB Centre |
|
Drugs:
Name of Facility |
Functions |
District Drug Store |
|
State Drug Store |
|
Resources
Assessment
Question | Answer 1 | Answer 2 | Answer 3 | Answer 4 | Correct Answer | Correct Explanation | Page id | Part of Pre-Test | Part of Post-Test |
Which of the following is part of the PMDT structure under NTEP? | NACP | NACO | District Comorbidity Committee | None of the above | 3 | The district comorbidity committee is part of the PMDT district-level structure. The committee reviews and rectifies TB-comorbidity components with regard to HIV, diabetes, addiction and other review coordination with other health programmes like RBSK. | Yes | Yes | |
The PMDT organisational structure is based on functional roles that can be classified into diagnosis, treatment and drugs. | True | False | 1 | The PMDT organisational structure is based on functional roles that can be classified into diagnosis, treatment and drugs. | Yes | Yes |
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