Interaction of STS with TB Patient Care Ecosystem

The Senior Treatment Supervisor (STS) interacts with the patient care ecosystem from the time a person with TB is notified, diagnosed and anti-TB treatment is initiated.

The key interactions include:

• Coordination with laboratory technician and Senior TB Lab Supervisor (STLS) for results of TB diagnosis, follow-up, diagnosis, sending samples for drug susceptibility testing whenever required.
• Clinical evaluation of the patient by a Medical Officer (MO) and follow-up evaluation.
• The STS conducts home visits to provide health education and counselling on nutrition and treatment adherence to the patient and family/ caregivers, and for monitoring treatment progress till successful completion of treatment.
• The STS supports the health facility staff to update the information of patients on Nikshay, including on comorbidity, treatment adherence, treatment outcome, contact investigation and their TB Preventive Treatment (TPT).
• Interactions with the District Drug Store (DDS), pharmacist and District TB Centre (DTC) to ensure an adequate supply of drugs for the patient.
  • Uses Nikshay Aushadhi for drug request generation, managing drug inventory, dispatch and issue to patients.
• The STS supports assigning treatment support centres and treatment supporters for the patient. The treatment supporters may be community volunteers accessible, willing and acceptable to the patient and who can be accountable to the health system. These include Anganwadi workers, dais, teachers, panchayat leaders, religious leaders, and others.
• The STS coordinates with District TB Officer (DTO) and DTC to ensure the disbursement of incentives to patients under Nikshay Poshan Yojna, incentives to treatment supporters and travel incentives to Drug-resistant TB (DR-TB) patients.
• The STS is crucial in organising community-based Information, Education and Communication (IEC) activities like patient-provider group interaction meetings and community meetings in coordination with the support of field staff, which includes the Community Health Officer (CHO), Multipurpose Health Worker (MPHW), Auxiliary Nursing Midwife (ANM).
• STS works in coordination with the DR-TB coordinator to ensure diagnosis, pre-treatment evaluation, treatment initiation, adherence and follow-up for all DR-TB patients.
• Ensures standards of TB care in India are followed for patients diagnosed in private health facilities.

Resources

• Training Modules (1-4) for Programme Managers and Medical Officers, NTEP, 2020.  
• Module for Senior Treatment Supervisors, RNTCP, CTD, 2005. 
• Guidelines for PMDT in India, 2021.

Assessment