Determining the priority activities

The key priorities should be aligned with National Strategic Plan guidance document. The following priority areas may assessed for NHM PIP with focusing on the program strengthening and achieving key deliverables. 

Detect

• Active case finding: Vulnerability Mapping & Active case finding
• Expand molecular tests: Scale up Molecular Diagnostics to the Peripheral Levels
• Private sector engagement 
• Effective sample transport for confirmation of TB and Early Detection of DRTB- Universal DST
• Health facilities under other Government sector units: Decentralize TB screening to AB-HWC levels

Treat

• DST and Shorter regimen : Daily regimen –Fixed Dose Combination, Injection free treatment regimens
• Use of Digital adherence technology but ensure and sustain treatment success more than 90%
• Differentiated care and targeted management of high-risk TB patient for reducing morbidity and mortality
• Free drugs to private sector : Expand access of Bedaquiline/ Delamanid to DRTB patients including in private sector along with monitoring of adherence to treatment
• Post treatment follow up at 6, 12, 18 and 24 months

Prevent

• TB Infection testing and TB Preventive Treatment : Scale up of TPT among targeted populations
• Airborne Infection Control: Airborne Infection Control  in community & Health Facilities; Airborne infection prevention protocols and measures in quality control programmes – NQAS, Kayakalp etc. 
• Workplace policy

Build

• Multisectoral engagement for demand generation and stigma reduction
• Community Engagement & TB Champions
• Human Resources Development
• Procurement & Supply Chain Management
• Contracting & Strategic Purchasing - PMJAY package expansion
• eTraining and digital interventions across the system
• Awareness – TB Mukt Bharat Campaign
   

Operationalization of TB services at AB-HWCs and training of CHOs on TB care and prevention

Disease free certification in eligible districts and/or at State/UT level.

Integration with Other Components of NHM: 

• Intensified screening – HWC, ICTC, ART, NCD, Tobacco, IDSP, RBSK, RKSK, Ayush etc.
• Surveillance: Use all possible surveillance sources – IDSP, Covid, Death Registration and Audit system
• Mobile diagnostic van and transport services of NHM
   

Resources: 

1. National Strategic Plan 2017-2025 for TB Elimination in India

Assessment