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PMDT Review Mechanisms
Learning ObjectivesExplain the PMDT review mechanism at various levels, crucial indicators to review, and different committees taking the onus of review.
Alongside regular monitoring through Ni-kshay application, National TB Elimination Programme (NTEP) also recommends conducting periodic meetings at various levels across the country to review the Programmatic Management of Drug-resistant Tuberculosis (PMDT).
These meetings help the programme through discussions and reviews of various aspects such as updates on guidelines, performance tracking, and taking corrective actions in order to address the implementation challenges wherever required.
PMDT Review Mechanism at Various Levels
| Level | Meeting | Chair | Frequency | Participants/ Committees |
| National level | Biannual National State TB Officer (STO) - Consultants’ meeting | Deputy Director General (DDG)- TB | Annual | STOs & state PMDT coordinators in the region |
| Regional PMDT review meeting | World Health Organisation (WHO) NTEP Regional Team Leads (RTLs) & consultants | |||
| State-level | State PMDT committee meeting | Principal Secretary (Health)/ Managing Director (MD) National Health Mission (NHM) | Quarterly | Members of state PMDT committee |
| District TB Officers (DTO) quarterly review meeting | MD NHM/ STO | Quarterly | Concerned NHM and State TB Cell (STC) officials, State TB Training and Demonstration Centre (STDC), Intermediate Reference Laboratory (IRL), Culture and Drug Susceptibility Testing (C&DST) lab and DTOs | |
| Nodal DR-TB Centre (NDR-TBC) site coordination meeting | Nodal officer/ Senior medical officer – NDR-TBC | Quarterly (1st week of each quarter) | Concerned NDR-TBC staff & all senior DR-TB TB-HIV supervisors of the districts linked to NDR-TBC | |
| District-level | NTEP review meeting of the Medical Officer – Tuberculosis Units (MO-TU) | District magistrate/ Chief medical officer/ DTO | Monthly | District programme managers, MO-TU, medical college nodal officers, DR-TB nodal officers, In-charge/ microbiologists C&DST lab, Senior Treatment Supervisor (STS), Senior Tuberculosis Laboratory Supervisor (STLS), Tuberculosis Health Visitor (TBHV), Laboratory Technician (LT), General Health System (GHS) staff |
| Block Level | NTEP performance review | MO-TU/ Block medical officer | Monthly | Block medical officer/ MO-TU, TU staff (STS, TBHV, STLS), Health Facility (HF) staff |
| Health Facility (HF) level | NTEP performance review | MO-HF | Monthly | STS, TBHV, STLS, HF staff including Community Health Officer (CHO) & team |
Following are the key indicators* reviewed during a PMDT review:
- Coverage of Universal Drug Susceptibility Testing (UDST)
- Profile of resistance pattern reported for patients during that period
- Turn-around time for lab activates
- DR-TB notification rate
- DR-TB treatment initiation rate within 7 days of diagnosis
- DR Treatment adherence rate (both treatment interruption and lost to follow-up (LTFU))
- Counselling and rate of retrieval or treatment interrupting/ LTFU patients
- Interim smear/ culture conversion rate as per various regimen
- Resolution of serious adverse events
- Treatment outcomes
- TB Preventive Treatment (TPT) Coverage and completion rate
- Direct Beneficiary Transfer (DBT) coverage rate
(*All indicators are disaggregated and reviewed across age, gender and type of drug resistance.)
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Assessment
| Question | Answer 1 | Answer 2 | Answer 3 | Answer 4 | Correct answer | Correct explanation | Page id | Part of Pre-test | Part of Post-test |
| At what level under the NTEP are the Regional PMDT review meetings conducted? | National | State | District | Block | 1 | Regional PMDT review meetings are conducted at the national level and are attended by the World Health Organisation (WHO) NTEP Regional Team Leads (RTLs) & consultants. | Yes | Yes |
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