Senior DR-TB/TB-HIV Supervisor and their role

The roles of the Drug-resistant TB (DR-TB) HIV Coordinator are:

1. Providing technical assistance to District TB Officer (DTO) for:

• Organising Programmatic Management of Drug-resistant TB (PMDT) services in the district
• Supporting District DR-TB Centre (DDR-TBC) for data management in Ni-kshay and their coordination with Anti-retroviral Therapy (ART) centre in the districts
• Organising TB-HIV coordination activities in the district
• Providing training to the staff of health facilities (public and private) under their jurisdiction to carry out PMDT and TB-comorbidity-related activities
• Conducting monthly reviews with TB Unit, National AIDS Control Programme (NACP), and Health and Wellness Centre (HWC) staff using dashboards and analysis of data from Ni-kshay periodically to address implementation and management gaps
• Activities related to drug and logistics supply chain management of drugs for PMDT, Cotrimoxazole Preventive Therapy (CPT) and Isoniazid Preventive Therapy (IPT) and modified TB regimen for People Living with HIV/AIDS (PLHA) with TB on second-line ART
• Coordinating regular sharing of the information related to TB-HIV coordination by assisting the nodal officer
• Mapping, prioritising, and engaging health facilities and laboratories in the private sector, Non-government Organisations (NGOs) and other sectors to improve access and quality of DR-TB care for all as per guidelines
• Preparing and maintaining a directory of Integrated Counselling and Testing Centres (ICTCs), ART centres/ Link ART Centres (LACs), community care centres, Non-communicable Disease (NCD) clinics, private health facilities and NGOs working for HIV, NCD in the district and the collaborating National TB ELimination Programme (NTEP) centres
• Providing a monthly activity report to the DDR-TBC committee and DTO.

2. Coordinating for smooth programme implementation

• Coordinate with all health staff and facilitate to subject all TB patients to universal Drug Susceptibility Testing (DST) at the linked decentralised Nucleic Acid Amplification (NAAT) sites and NTEP certified laboratories in the public and private sectors.
• Ensure that initial home visits are conducted by health workers to all newly diagnosed DR-TB patients of the district.
• Ensure that staff organises treatment support, all public health actions, follow-up reminders and transportation support for DR-TB patients.
• Help staff in proactive reach out to patients for follow-up cultures/ investigations as per schedule for every patient.
• Coordinate with and support TB Units, HWCs staff and private doctors to regularly update the directory of treatment supporters for DR-TB patients at the district level and facilitate their training.
• Facilitate the DR-TB treatment initiation at DDR-TBC.
• Ensure PMDT treatment books are updated for all patients at DDR-TBC, TB Units (TUs) and HWCs.
• Ensure and monitor the PMDT data completion in Ni-kshay and give periodic TU/ Peripheral Health Institute (PHI)-wise feedback to the DTO about the same.
• Liaise with respective Nodal Drug-resistant TB Centres (NDR-TBCs) for updating information on Ni-kshay and patient care.
• Ensure complete, correct and timely compilation and transmission of PMDT/ TB- HIV information.
• Establish linkages with the District TB Centre (DTC), District AIDS Prevention Control Unit (DAPCU), collaborating NGOs and hospitals of the district.
• Facilitate change management with respect to the use of Information, Communication and Technology (ICT) tools, Ni-kshay, Ni-kshay-Aushadhi for concerned data entry, validation & its use for public health action.
• Support DDR-TBC in updating the template with information to be shared with difficult-to-treat TB clinic for selected patients as per directions from the DDR-TBC committee and management of the patient based on recommended actions from the clinic.

3. Supervising and monitoring

• Monitor time to treatment of DR-TB patients and provide feedback on a periodic basis. 
• Supervise all DR-TB patients and treatment support centres along with concerned TB Units, HWCs staff and private providers.
• Evaluate referral systems between ICTCs, ART centres, NCD, and NTEP and promote providing feedback to the referring centre.
• Field visits in the districts for at least 15 days a month, including Joint TB-Comorbidity visits on a tour programme approved by DTO.

4. Capacity building and imparting skills

• Train and supervise the pharmacists/ responsible staff of district/ TB Unit/ HWC drug stores in maintaining adequate stock of second-line drugs.
• Train staff for preparation of monthly patient-wise boxes by regimen and weight band as well as initialisation of Medication Event Reminder Monitor (MERM) devices, as available, for every patient initiated on DR-TB treatment at the NDR-TBC as per guidelines.

Resources

DO Letter - TOR and Needs Norms for NTEP Staff, 2021. 

Assessment