Community mobilization strategies-Tribal areas

Tribal people (10.4 Cr, 8.6% of total population) have higher prevalence (703 per 100,000) of TB compared to national average (256 per 100,000).10.4% of all TB notified patients are from tribal communities. The National TB program has prioritized this subgroup of population through Tribal Action Plans since 2005.

As a part of the Multisectoral collaboration with various Ministries, a guidance note on the joint action plan was developed by Ministry of Health and Family Welfare (MoHFW) and Ministry of Tribal Affairs in October 2020 and shared with the Secretaries of all States/ UTs for field level implementation. Tribal TB initiative, a unique partnership between the Ministry of Health and Family Welfare and Ministry of Tribal Affairs was initiated to improve the cascade of TB care and support services among Tribal Populations in India. The technical assistance for this initiate will be provided by USAID.

Challenges in communities in tribal areas:

Access, availability, and utilization of TB care services of these communities are hindered by:

1. Geographical barriers
2. Poor state of social determinants
3. High impact of malnutrition, insufficient community involvement
4. Health system constraints including lack of trained human resources
5. Cultural and communication gaps between the care provider and the community, etc.
6. The COVID-19 pandemic has probably further worsened the situation.

Community mobilization strategies in tribal areas:

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Various departments which play a role in community mobilization in Tribal areas:

1. National Program Management Unit (NPMU) provides technical assistance in monitoring and implementation of the Tribal TB Initiative.
2. Coordination among National Tuberculosis Elimination Programme (NTEP), National Health Mission (NHM), Ministry of Development of Northeastern Region, Ministry of Tribal affairs at National, state and district levels through national level Technical Support Unit.

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3. Coordination with ‘Centre of Excellence’ within the Ministry of Tribal Affairs, with a key focus on TB.
4. Partnering with private sector players for leveraging resources for TB elimination in Tribal communities.
5. Documenting best practices, and commission tribal health research studies in collaborations with identified government institutions.
6. Various departments collaborate for improving the operational excellence of existing demand-side interventions such as Village Health Sanitation and Nutrition Days (and committees), Jan Arogya Samiti platforms, Jan Andolan initiatives, engaging TB-Champions, and training of faith healers and other community influencers.

Resource

1. Operational handbook on Advocacy, Communication & Social Mobilization for RNTCP, Central TB Division, MoHFW, GoI 2014  

2. Tribal TB Iniative

3. NTEP Training Modules 5to9

Assessment