[Draft] Trainer's guide for the Course for MO-PHI on NTEP

Introduction

Targeted Trainees: Medical Officer- PHI includes generally all Medical Officers placed at Government Health facilities at primary, secondary and tertiary levels. This does not include Medical Officers that have specified roles in the NTEP program, such as Medical Officers at, District / Nodal DRTB-Centres, Medical Colleges, MO-TC. 

Qualified Trainers: Trainers may be other Medical Officers at the District Level or above that are prior identified by State such as DTOs, MO-TCs who are in-turn trained on their cadre's corresponding course on NTEP. 

Trainers are selected based on their ability to conduct training in an interactive and interesting manner. The Trainers should have completed their own cadre-wise course, thorough with this trainers guide and must possess strong knowledge about the NTEP, and the various processes related to patient workflow and Ni-kshay. The Trainers should be well versed with the supporting IT systems such as those for video conferencing (Zoom/ Teams/ Google meet), Learning Management System (Swasth-eGurukul), Ni-kshay, etc. 

Mode of Training: Training may be provided by utilizing the blended approach where a mix of training methods and modes may be used to execute the training. 

Training Institution: The training of MO-PHI is to be organized by the District TB Centre. 

Recommended Batch size: 25.

Training Duration: The training course content has 4 modules with a total of 18 chapters. A trainee needs to complete this course in about a total 16 hours. The Module wise breakup is provided below

Sr.

Module

Duration
1 Basics of TB and NTEP 2hrs 
2 Case Finding and Diagnosis 3hrs
3 TB Treatment and Management 7hrs
4 Program Management and Programmatic actions 4hrs

Chapter wise detailed instructions for Trainers

Module 1: Basics of TB and NTEP
Chapter 1.1 TB & TB Epidemiology Mode: Self Learning
Emphasis Points
  1. TB is an important public health problem for India and accelerating progress toward the END TB Targets (2015-2035) is a priority for the country
  2. Progression to TB disease exists as a continuum, with two distinct stages (infection and disease)
Post Session Activity  
Chapter 1.2 NTEP Mode: Self Learning
Emphasis Points
  1. India's commitment to ENDING TB 5 years ahead of global Targets
  2. The PHI is a the 5th level in NTEP hierarchy; the only one responsible for actual service delivery. 
  3. The MO-PHI is the leader and program manager at this level for the population catered to by the PHI. 
Post Session Activity  
Chapter 1.3 Information Systems in NTEP Mode: Self Learning
Emphasis Points
  1. Ni-kshay is the information system of the TB program
  2. It has different interfaces for various stakeholders ranging from Patient's to program managers
  3. The various stages in a person's care identified in Ni-kshay and the actions to be performed at each stage by which stakeholder.
Post Session Activity  
Module 2: Case Finding and Diagnosis
Chapter 2.1  General Concepts in TB Case Finding  Mode: Self Learning
Emphasis Points
  1. Highlight the various steps in case finding from screening to confirmation of diagnosis.
  2. The policy of and definitions bidirectional screening and UDST. 
Post Session Activity  
Chapter 2.2 Diagnostic Technologies and Lab Network Mode: Self Learning
Emphasis Points
  1. Rapid Molecular Test as a highly sensitive tool for diagnosis of TB
  2. Three tier hierarchy (NRL, IRL, Service Labs- NAAT/ C&DST /Microscopy)
  3. Role of Sputum/ Specimen Collection and Transportation Centre
Post Session Activity  
Chapter 2.3  Diagnostic Specimen Mode: Self Learning
Emphasis Points
  1. Good quality sputum being mucopurulent, early morning sample.
  2. Patient TAT is monitoried by the Programme. It includes processes from specimen collection to reporting the test result and is longer than the time taken to perform a test.
Post Session Activity  
Chapter 2.4  Active Case Finding Campaign Mode: Self Learning
Emphasis Points
  1. ACF is conducted in vulnerable populations to detect cases early. Vulnerable population mapping is the first step in the ACF campaign.
  2. ACF is conducted to find cases early directly from the community.
  3. Yield of ACF is depends on the sensitivity of the screening and diagnostic Technology / algorithm used.
Post Session Activity  
Module 3: TB Treatment and Management
Chapter 3.1 General Concepts in TB Treatment  Mode: Self Learning
Emphasis Points
  1. DSTB Treatment is made of 4 drugs given as FDCs weight band wise doses
  2. Process of treatment starts from initiation to end of long term followup
  3.  
  
Post Session Activity    
Chapter 3.2  TB Treatment and Care Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 3.3  Treatment Support  Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 3.4  Adherence Management  Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 3.5  TB and comorbid conditions Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 3.6  Infection Prevention & Control  Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 3.7  TB Preventive Therapy Mode: Self Learning
Emphasis Points  
Post Session Activity  
Module 4: Program Management and Programmatic actions
Chapter 4.1  Public Health Actions Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 4.2  Patient Support Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 4.3  Social Inclusion and wellness activities  Mode: Self Learning
Emphasis Points  
Post Session Activity  
Chapter 4.4 Programme Monitoring Mode: Self Learning
Emphasis Points    
Post Session Activity