INTRODUCTION
India accounted for more than 25% of the global TB burden. To End TB, various interventions are planned by the Centre and State under the National Tuberculosis Elimination Program (NTEP).1 Operational Research is one of the requisites to generate continuous evidence to ensure state strategies are aligned well with the National Program. This evidence informs change in interventions or policy and optimize implementation of program activities to improve overall health outcomes.2  


The National Strategic Plan for TB Elimination in India encourages and promotes Operational Research (OR) activity. Central Tuberculosis Division (CTD) has published areas and priorities for operational research at state, zonal and national level. The ‘Revised Norms and Guidelines for STDC’3 recommend STDCs to independently plan and execute need-based operational/implementation research and inform effectiveness of interventions at State.

However, most of the STDCs in the country are unable to conduct research activities due to underlying deficiencies in the systems or capacities. STDC Delhi has been conducting research studies regularly. Most of the projects have been conducted in collaboration with Indian Council of Medical Research (ICMR), National Institutes for TB, Medical colleges at New Delhi, Delhi TB-Association and development agencies like FIND (the global alliance for diagnostics), The UNION (International Union Against TB and Lung Disease), MRC-London (Medical Research Council), Centre for Equity etc. Around one-third of the total research projects undertaken by STDC Delhi in past 7 years are Operational research projects.

Since 2016-17, 102 research projects have been published as formal research papers, 56 of them have been published in the past 3 financial years. Some of the findings from these research studies have been incorporated into practice under NTEP. Findings from studies like National Sample survey for TB in 1950, eight longitudinal disease prevalence surveys conducted in domiciliary area of STDC Delhi for over 30 years, Active Case Finding (ACF) campaign in homeless pavement dwellers along Yamuna Pushta with mobile X-ray van supported by Medanta Medicity in Gurugram4 and prevalence of initial and acquired drug resistance and outcomes of Short-course chemotherapy (SCC) are some of them.

STDC Director and the staff has participated in 889 scientific events in last decade (since 2014-15) which has resulted in collaborations, cross-learning, funding and more research opportunities. The staff has gone an extra mile in presenting their research projects and findings at National (19) and International (13) scientific platforms. This document captures the experiences of STDC Delhi in conducting an operational research and key learnings. The enabling factors are listed in detail as an information for other STDCs to enhance replication and uptake.

STDC Delhi
Established in 1940 by Government of India and TB Association of India4 (TAI) jointly, officially known as New Delhi TB Centre (NDTBC) functioned as a model clinic for initiating organized domiciliary treatment for TB. In 1951, the center upgraded to first TB Training and demonstration center (TDTC) to provide training to health care workers and diagnostic referral center for five northern states until formal declaration as an STDC in 2005. Since then, STDC Delhi has been actively promoting operational research with the prime objective of evolving patient friendly and cost-effective treatment to people with TB. The details of the research activities and projects may be assessed from the annual reports published by STDC Delhi.4

1.https://tbcindia.mohfw.gov.in/wp-content/uploads/2023/06/5646719104TB_A…
2.theunion.org/sites/default/files/2024-06/Union OR to Improve Health Services 2nd 2024.pdf
3.https://tbcindia.mohfw.gov.in/wp-content/uploads/2024/08/Norms-and-Guid…
4.https://www.ndtbc.com/annual-report