Determining activities under each priority need

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. 

TB Case Finding

• Setting up/strengthening of TB diagnostic services
• Setting up/ strengthening of X-Ray services at least at block level through health systems/outsourcing
• Private sector engagement through domestic PPSA and transition of JEET PPSA
• Deployment of sample collection and transportation (a) for diagnosis of TB from peripheral levels to DMC, molecular lab, (b) for UDST from DMC to molecular lab and (c) for CDST from DMC/molecular lab to CDST LAB/IRL 
• Vulnerability mapping of individuals / households annually and Active Case Finding in vulnerable population quarterly
• Decentralization of procurement of all lab consumables used under National TB Elimination Programme (NTEP)

TB Prevention and Building community involvement

• Strengthen TPT for PLHIV and household contact persons < 5 years and Scale up of TPT in adolescents, adult contacts at house-hold & workplace of pulmonary TB patients & other risk group 
• Refer - ‘Guidance Document on Community Engagement under National Tuberculosis Elimination programme’, for planning activities for  Community engagement and State / District TB Forum
• Create pool of TB Champions, two (one male and one female) in each block
• Strengthen ACSM activities as per the TB Mukt Bharat Calendar of activities and additional needs as per local context.
• In addition, plan for (a) sensitization of SHGs, Youth Clubs, Community networks, (b) sensitization of MLAs, PRIs and elected representatives in urban local bodies, (c) community events through AB-HWCs on 24th of every month, (d) plan for mid-media activities like wall paintings, miking, street plays, posters, banners, hoardings, etc.

TB Treatment

• Strengthen access of Anti-TB drugs (FDCs) to patients in private sector and Expand access of Bedaquiline/ Delamanid to DRTB patients including in private sector along with monitoring of adherence to treatment
• Implement Differentiated TB Care Guidelines for identification and targeted management of high-risk TB patient for reducing morbidity and mortality
• Strengthen all DBT schemes including Nikshay Poshan Yojana
• Estimate requirement for local procurement of medicines and indent for kind grant for central supplies of drugs
• Mandatory establishment of DR-TB facility in all the Medical Colleges establishment of Centre of Excellence (CoE) for DR-TB 

Human Resource

• Redeployment of NTEP HR from Covid duty back to TB and Proposal for additional STS/STLS/LT/TBHV based on workload. NHM may be used to provide performance-based incentives. 
• Training is to be taken up as a priority area. training calendar and plan training activities for NTEP staff. 
• To increase the involvement of General health System/ NHM staff in TB, their continued sensitization/ training in NTEP maybe planned.
• STDCs form a critical element of NTEP functioning at the state. The States have to plan to setup, and or strengthen STDCs with necessary infrastructure/ personnel to perform Programmatic Training and Supervision, M&E activities.
   

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: RMNCHA+N programs, IDSP etc. 

Resources: 

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

Assessment