Introduction
The purpose of this document is to provide the course coordinators and trainers for the ‘Course for STS in NTEP’ guidance for planning and executing the training. The targeted trainees for this course would be:
- Senior Treatment Supervisor (STS)
- Tuberculosis Health visitor (TB-HV)
This training may be provided by utilizing the blended approach where a mix of training methods and modes will be used to deliver content. This would include either in-person/ virtual training or facilitator led/ Self learning/ demonstration and role plays. Training sessions which require hands-on training will be conducted only in a physical setting. Keeping in mind the aforesaid best practices of the Modernized Training System, each State Office may decide to choose the approach which is most suitable for their State.
The training of STS to be conducted at State/Regional level preferably at the STDC. The batch size for Physical Session/Virtual Sessions should not be more than 25.
For virtual sessions, the trainees will be going through the online content, and attempt quizzes after each module. An instructor-led session will also be conducted for each module. This will help the trainees for better clarification of contents and to address the queries and doubts.
For the training areas which require hand-holding of trainees like demonstration of processes- like patient management in Ni-kshay, filling of various forms, Adherence Management tools, recording information on Public Health action, use of NI-kshay Aushadhi, etc in-person training sessions need to be conducted.
The training course content has 11 modules and 43 chapters. Based on different modalities used for the training, the training delivery should take at least 40 hours.
For the purpose of assessment of trainees, a pretest before the beginning of training, interim quizzes at the end of each module and a post-test at the end of training has been configured in the course content. The certificates are auto-generated for the trainees in their LMS account on successful completion of post-test and their performance in interim quizzes.
Training curriculum / Agenda
Sr. |
Module |
Chapters |
Training Modality |
Duration (Hrs) |
---|---|---|---|---|
1 | Basics of TB and NTEP |
|
Virtual
|
4 |
2
|
TB Diagnosis and Case finding |
|
Virtual |
4
|
3 | TB Treatment and care |
|
Virtual |
4
|
4 | Adherence Management |
|
Physical | 4 |
5 | Public Health Action |
|
Physical |
4
|
6 | DBT |
|
Physical | 4 |
7 | Supervision, Monitoring and Evaluation |
|
Physical | 4 |
Supply Chain Management in NTEP |
|
Physical |
4
|
|
9 | Private sector Engagement |
|
Virtual |
2
|
10 | ACSM and Community Engagement |
|
3 | |
11 | Training the Health Volunteers and Treatment Supporters |
3
|
Trainers
For this course, following personnel may be appointed as the trainers:
- MO - STDC
- MO - STC
- WHO-consultants
- DTO (select)
- SDS/DDS Pharmacists (Select)- for Supply chain and drug distribution module.
Trainer Eligibility
Trainers are selected based on their ability to conduct training in an interactive and interesting manner. The Trainers should have completed the ‘Course for STS’ and they must possess strong knowledge about the NTEP and the various processes related to patient workflow, Niskahy and Niskahy Aushadhi. The Trainers need to go through the Chapter- wise Training Guide for this Course, provided as an Annexure.
The Trainers should be well versed with the IT systems, for video conferencing (such as Zoom), Learning Management System (such as Swasth-eGurukul), Ni-kshay and Ni-kshay Aushadhi.
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Chapter wise detailed instructions for Trainers
The aim of providing chapter-wise detailed instructions provides the Trainers with the following:
- Module-wise and Chapter-wise, modality that may be adopted (virtual/ Physical/ In-person)
- The estimated time to complete the content.
- The key messages that a trainer should emphasize upon, while delivering the training
- The activities which should be conducted at the end of each chapter / session to ensure learning effectiveness. This may include asking specific questions, demonstrating processes, discussing various forms and equipment. If any Module specific physical visits are required to be conducted, such details are also provided here.
This guiding document will also aid in bringing uniformity with respect to the content and quality of training conducted across the entire state and nation.
Module 1: Basics of TB and NTEP Virtual Session (4 hours) | ||
---|---|---|
Chapter 1.1 | TB & TB Epidemiology | Virtual Session (60 min) |
Emphasis Points |
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Post Session Activity |
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Chapter 1.2 | NTEP | Virtual Session (45 min) |
Emphasis Points |
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Post Session Activity |
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Chapter 1.3 | Integration of NTEP with Health System | Virtual Session(30 mins) |
Emphasis Points |
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Post Session Activity |
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Module 2 | TB Diagnosis and Case Finding | Virtual Session (4 hours) |
Chapter 2.1 | Diagnostic Technologies | Virtual Session (30 min) |
Emphasis Points |
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Post Session Activity |
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Chapter 2.2 | Diagnostic Network & Hierarchy | Virtual Session (30 min) |
Emphasis Points |
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|
Post Session Activity |
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Chapter 2.3 | Approaches to TB Case Finding | Virtual Session (30 min) |
Emphasis Points |
|
|
Post Session Activity |
(i) Screening for active TB in a Diabetic Clinic & testing those who screened positive (ii) Screening for active TB in an elderly home & testing those who screened positive (iii) Screening for active TB in cancer wards & testing those who screened positive |
|
Chapter 2.4 | TB Case Finding in NTEP | Virtual Session (30 min) |
Emphasis Points |
Diagnostic algorithm for Pulmonary TB- Role of Chest X ray as a screening tool and the need to complete the diagnostic algorithm. Classification of TB on the basis of site,diagnosis, drug resistance
|
|
Post Session Activity |
Discuss: “What proportion of presumptive TB patients in your TU completes the diagnostic algorithm? What are the implications if the people are not completing the diagnostic algorithm?”
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|
Chapter 2.5 | Active Case Finding Campaign | Virtual Session(45 mins) |
Emphasis Points | Step by step process in planning and execution of an ACF campaign with special emphasis on identification of target population, need for micro planning and need to prevent the leaks in the cascade of care. | |
Post Session Activity | Discuss how they monitor the ACF in their TU against ‘Cascade of Care? What are the measures they undertake to prevent the leaks in ‘’Cascade of care’’? | |
Module 3: | TB Treatment and care | Virtual Session (4 hours) |
Chapter 3.1 | General Concepts in TB Treatment | Virtual Session (60 mins) |
Emphasis Points |
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Post Session Activity |
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Chapter 3.2 | DS-TB Treatment and Care | Virtual Session ( 30 mins) |
Emphasis Points |
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Post Session Activity |
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Chapter 3.3 | DR-TB Treatment and care | Virtual Session (30 mins) |
Emphasis Points |
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|
Post Session Activity |
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Chapter 3.4 | Different DR-TB Regimens | Virtual Session (15 mins) |
Emphasis points |
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Chapter 3.4 | TB Infection treatment and care | Virtual Session (30 min) |
Emphasis Points |
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Post Session Activity | Role Play- Counseling for TPT | |
Chapter 3.5 | TB Co-morbidity and special situations | Virtual Session (30 min) |
Emphasis Points |
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|
Post Session Activity |
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Module 4: | Adherence Management | Physical Session (4 hours) |
Chapter 4.1 |
Patient Management |
Virtual Session (60 mins) |
Emphasis Points |
How the information of patients is managed through Ni-kshay (Enrollment, Request for Test). |
|
Post Activity Session |
Call two participants to demonstrate how they (1) enroll a subject and (2) request for Test in Ni-kshay Make all participants to view their task list in Ni-kshay and discuss how they are going to use the feature |
|
Chapter 4.2 | General concepts in Adherence management | Physical Session (60 mins) |
Emphasis Points |
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Post Session Activity |
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Chapter 4.3 |
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Physical Session (60 mins) |
Emphasis Points |
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|
Post Session Activity |
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Chapter 4.4 | Chapter: 99 DOTS | Physical Session (30 mins) |
Emphasis Points |
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Post Session Activity |
Scenario 1: One of their patients complained that she used to dial the toll-free number every day and used to hear “Thank You” also. But when you check, the Nikshay dashboard is still showing red.
Scenario 2: One of your clients with TB called you and told you that his call is not going to the ‘toll free’ number because of ‘insufficient’ balance. |
|
Chapter 4.5 | Chapter: MERM | Physical Session (30 mins) |
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Chapter 4.6 | Chapter: Monitoring of adherence | Physical Session (60 mins) |
Emphasis Points | Participants need to be empowered to use adherence summary dashboards and interpret the indicators. | |
Post Session Activity |
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Module 5: | Public Health Action | Physical Session (4 hours) |
Chapter 5.1 | Patient Support | Physical Session (60 min) |
Emphasis Points |
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Post Session Activity |
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Chapter 5.3 | Contact Investigation | Physical Session (60 mins) |
Emphasis Points |
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Post Session Activity |
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Chapter 5.4 | Counselling and Education | Physical Session (60 mins) |
Emphasis Points |
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Post Session Activity |
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Module 6: | DBT | Physical Session (4 hours) |
Chapter 6.1 | General Concepts in DBT | 60 mins |
Emphasis Points |
This is an overview chapter.
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Post Session Activity |
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Chapter 6.2 | Processes in DBT | 150 mins |
Emphasis Points |
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Post Session Activity |
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Module 7 | Supervision, Monitoring & Evaluation | Physical (4 hours) |
Chapter 7.1 | Supervision | 60 minutes |
Emphasis Points |
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Post Session Activity |
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Chapter 7.2 | Program Monitoring Indicators | 120 minutes |
Emphasis Points |
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Post Session Activity |
Assignment: Each participant needs to calculate any 3 indicators in their TU based on real time data and interpret those indicators.
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|
Module 8 | Supply Chain Management | Physical (4 hours) |
Chapter 8.1 | General Concepts | 60 mins |
Emphasis Points |
General Concepts of SCM
|
|
Post Session Activity | Ask for any doubts from the participants and clarify the same. | |
Chapter 8.2 | Stocking Norms | 30 mins |
Emphasis Points | Buffer stocks and storage norms | |
Post Session Activity | Reinforce the concepts of buffer stock and storage norms. | |
Chapter 8.3 | Supply chain process | 150 mins |
Emphasis Points |
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Post Session Activity |
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Chapter 8.4 | Drug dispensation Module | 30 mins |
Emphasis Points |
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Post Session Activity |
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Module 9 | Multisectoral Sector Engagement | Virtual (2 hours) |
Chapter 9.1 | General Concepts | 30 mins |
Emphasis Points | Why private sector engagement is important and what is the Vision of NTEP on private sector engagement. | |
Post Session Activity |
|
|
Chapter 9.2 | Models of Private Sector Engagement | 60 mins |
Emphasis Points |
Explain PPSAs, Direct Option for engagement. Explain STEPS |
|
Post Session Activity | Ask each of the participants to think what model suits for private sector engagement in their TU and why. | |
Chapter 9.3 | Partnership Guidelines | 30 mins |
Emphasis Points | Emphasis on various options under partnership options | |
Post Session Activity | Discuss what all partnership options are currently existing in their TUs and what would they want to have. | |
Chapter 9.4 | Regulations | 30 mins |
Emphasis Points | Regulations of Mandatory TB Notification and Schedule H1 | |
Post Session Activity | Discuss how information from schedule H1 could be used? (Clue: Most crucial field in the schedule H1 register is the name of the provider who prescribed it. Information from Schedule H1 register could be used to Identify the provider prescribing the anti TB drugs and prioritize for engagement, Identify missing TB cases) | |
Module 10 | ACSM and Community Engagement | Physical (3 hours) |
Chapter 10.1 | General Concepts in ACSM | 60 mins |
Emphasis Points |
|
|
Post Session Activity | ||
Chapter 10.3 | Protocols for ACSM activities | 60 mins |
Emphasis Points | Organising Community Meetings, Peer group interventions, ACSM activities in schools | |
Post Session Activity | Discuss experiences form 1-2 participants regarding organizing community meetings | |
Chapter 10.4 | Community Engagement | 60 mins |
Emphasis Points |
LSGs and their role in TB Elimination TB Forums and what they can do What role can TB Champions play? |
|
Post Session Activity | Discuss what needs to be done to reduce stigma regarding TB in the community. Encourage everybody to discuss. |
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