Trainees

The targeted trainees for this course are generally those persons at the community level who would be interacting with the population for the purpose of on ground TB activities related to awareness, screening and Treatment Support. These may include:

1. ASHA Workers
2. Volunteers from NGOs, Community Representatives/ Youth Volunteers
3. TB Champions / Survivors/ Family Members
4. Workplace Representatives who volunteer for becoming focus for TB Services
5. Educators/ Teachers from Schools and Colleges

 

Trainers

The following cadres are supposed to be trained to become trainers on this course.

1. STS
2. TB HV
3. MO-PHI
4. MPHW/ Block Coordinators (NHM trainers)
5. DPC/ PPM Co-ordinators
6. NGO coordinators/ Supervisors
7. Representatives from Private/ Corporate sector

The capacity of these trainers to conduct the training for health volunteers will be in-built into their training and is considered as one of their essential competencies.

Training Methods

Teaching and discussing the course content using the standardised training content available on the NTEP approved LMS (such as Swasth-eGurukul). This training may use blended training delivery methods that are appropriate to the local context. This would include a mix of the following options

1. Traning Premises
   1. In-person
   2. virtual 
2. Mode of delivery
   1. Facilitator led
   2. Self learning
   3. Demonstrations
   4. practical exercises. 

In the blended mode, an instructor-led session should be conducted for each chapter. Simultaneously the trainees would go through the content available online themselves according to the schedule. Trainees need to attempt the quizzes after each chapter/module. 

At the end of each chapter/session the trainer/ facilitator should summarise the key messages of the chapter by engaging trainees through questions and discussions. The discussion should focus on aspects related to the competencies listed below. These sessions should also help the trainees to clarify doubts and queries. 

For the training areas which require hand-holding of trainees like to perform actual processes such as filling of forms, counselling/ addressing stigma, screening, sample collection, adherence monitoring, a demonstration/ role play mode may be adopted.

The duration of training content including discussions/ demonstrations/ role play, pre/post training assessments, is expected to be completed 6 hours. The course coordinator may schedule the course in multiple sessions totalling to this duration as appropriate.

Competencies of the Health Volunteer

The following ten competencies are important to a health volunteer. 

Competency	Assessment Protocol
1. Talk about TB, including Being an infectious respiratory disease It is curable Diagnosis of TB and Diagnostic services available in the Govt How to prevent TB (Ventilation, Sunlight, Cough etiquette)	Check ability to discuss with general public about TB and awareness of patient family members regarding TB during home visits.
2. Screen for TB using the 4 symptom complex	Check ability to screen a patient during house visits.
3. Refer for diagnosis to the nearest TB Testing Centre	Check ability to counsel patients, refer them to the nearest TB Diagnostic centre for TB Diagnosis, and record the referral during house visits.
4. Quality Sample collection and transportation	Check ability to, provide sputum cups to patients, spot and early morning sputum, counsel TB patients on good quality sputum collection, and transport the sample to the nearest health facility during house visits. May review with TB Diagnostic centre regarding quality of samples provided by the particular volunteer.
5. Record and Monitor Treatment adherence for TB Treatment, TPT *	Check ability to record doses taken, missed doses, and initiate patient retrieval incases of missed doses during house visits. May also review Nikshay Adherence scores of past or presently linked patients
6. Counsel patients *, and their family for  treatment adherence,  nutrition,  ADR addressing stigma	Check ability to counsel a patient on the 4 aspects during patient visit.
7. Refer for ADR management*	Check ability to actively check for ADR during patient visit and any linked patient remarks regarding how ADR was managed for them.
8. Post Treatment Followup*	Check whether up to two previously linked (Treatment completed) patients have all their post treatment follow up due completed.
9. Use Nikshay for performing the actions related to the above	Check ability to login, enroll and refer patients to health facilities, sample collection and transportation and also mark treatment adherence in Nikshay during patient visit.

The five (first four and last one) are core competencies of all volunteers while the remaining 5 (marked with *) are core competencies only if the volunteer acts/ intends to act as a treatment supporter.

 

The knowledge and training related to these competencies will be provided through the Course for Health Volunteers on NTEP and assessed through the pre and post test assessments/ quizzes.

 

Competency assessment needs to be done periodically(once in two years) or at the time of registration or initiation of the treatment regimen.

 

Pre-training Preparation

Before starting a batch of training, the following preparations need to be completed.

1. Confirmation of participants, trainees, trainers, venue, Training modality, equipment etc, related orders/ communication, instructions on (mobile devices, platform, registration process).   

2. Approvals on any TA/DA to be disbursed as per state policy  

3. Registration/ Enrollment of Trainees and batch formation on TIMS and on the LMS.

4. Creation/ confirmation/ Issue of Nikshay Usernames to the Health Volunteers  

5. Preparation of Props (Drug Blister packs, PWB, Specimen collection container, falcon tube, Specimen carry bags, IEC Materials )  

6. Internet connectivity facility, and audio visuals at any training sites  

7. Basic Facilities (Seating, toilet, canteen/ lunch area, drinking water)  

8. Refreshments

Chapter wise Trainers notes 

The course is divided into three modules, with a total of 11 chapters, each with specific learning and training objectives in alignment with the competencies of the person.  
The different scenarios and probes for the conversation and discussion have been covered in details at relevant sections. Three standard role plays have also been incorporated at the end of each module in the training course.  

 

Session	Activity	Duration
Session-1 (Introduction)	Introduction and Overview of course (The course structure should be explained that there are 3 modules and modules are further divided into chapters) NOTE: This session may be used as an ice-breaking session and to establish a rapport with the participants. It may also be emphasised here the importance of pre-test, quizzes and post-test assessment to successfully finish the course and obtain the certificate.	5 mins
Pre-test assessment	Note: This is Mandatory before proceeding with course content	10 mins
Module 1. Review module objectives with the participants and proceed to chapter wise content
Chapter 1-	Explain the TB disease and its significance in public health space. Explain the burden of TB Disease and efforts that need to be taken to fight this disease. (the Goal to end TB by 2025 may be mentioned here) Explain the causative organism of TB disease, mode of transmission and  its progression to active TB disease Explain the types of TB disease on the basis of sites of TB disease. The various sites of EPTB may be mentioned and explained in local language/context. Explain the difference between Tb infection and active TB disease Explain DS-TB and DRTB; various factors for development of DR-TB and difference between the two. Post Session activity: 1. Trainees may be asked about the various risk factors for developing TB disease. 2. Trainees may be asked about difference between TB infection and active TB disease.	20 mins

Planning Monitoring and Evaluation of Health Volunteers training.  

• Planning 
  • Creating and maintaining Database of Potential Trainees  
  • Creating and maintaining Database of Trainers  
  • Preparing batches and Training calendar  
• Monitoring  
  • Registration/ enrollment/ attendance  
  • Prep-post test assessment comparison,   
• Evaluation and QA  
  • Post training participant feedback  
  • Quality of training assessment by Observer    
  • Ongoing Competency assessment and identifying need for re-/update Training

Roles and responsibilities of Key Stakeholders