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Role of SHC-HWC in TB Case Management and Support
Learning Objectives-
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- Stock and dispense anti-TB drugs supplied from NTEP to the TB patients in the SHC catchment area.
- Support TB treatment adherence of the patient: Following the prescription of anti-TB drugs by the MO, the primary health care team led by the CHO at SHC HWC will identify appropriate treatment supporter in consultation with the patient, train him/her on giving drugs to the patient, dispense drugs to treatment supporter or patients, counsel patients on treatment literacy, cough etiquette, nutrition, fall back system in case patient has to move during the treatment, etc. SHC HWC can also act as treatment support centre for patients staying closer to it.
- Execute public health action for all diagnosed TB patients: This will include home visits, counselling, contact investigation, testing of blood sugar (if not done), mobilization/referral for chemoprophylaxis and HIV testing (if not done) to PHC-HWC, sample collection and transportation for DST (if not done), linkages to Antiretroviral Therapy (ART_ centre / DRTB centres (if needed), collection of bank account details and entering the same on Nikshay for facilitating Nikshay Poshan Yojana DBT, monitoring for adherence to treatment and facilitating follow up examination.
- Clinically monitor patients who are identified as at- risk for complications or death and facilitate care from appropriate facilities, whenever required. This includes monitoring general condition, nutritional status and Hb measurement, blood sugar and blood pressure monitoring of TB patients.
- Co-ordinate with the STS of the area and ensure regular updation of the records in hard copies as well as in Nikshay. The visits to the patient’s home can be coordinated with the STS of the area for better integration at the system level.
- Prevent treatment interruptions by regularly monitoring the patient’s drug intake and counselling the patient whenever there is likelihood of treatment interruptions.
- Identify Adverse Drug Reactions (ADR) and refer to the referral centre for management of ADR.
- Collect and transport the samples for follow up to nearby DMC as per the local need.
- Carry out long term follow-up of treated patients for next 2 years at 6 months interval, with support from ASHAs and update the records accordingly. ASHAs will mobilize the treated TB patients for follow-up assessments.
- Provide palliative care and also facilitate post-treatment rehabilitation of TB patient.
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