Role of Treatment Supporter in SCM

Ensuring adherence to correct treatment is crucial in the outcome of tuberculosis and hence it is essential to develop a patient-centred approach to treatment administration.

• A Treatment Supporter (TS) who is acceptable and accessible to the patient as well as accountable to the health system should be identified in consultation with the patient during pre-treatment evaluation.
• The TS can either be a healthcare worker, community worker/ volunteer or private practitioner or family member.
• If a family member is identified as TS s/he should be trained to give medication under supervision at the residence, under close monitoring by Community Health Officer (CHO)/ Accredited Social Health Activist (ASHA)/ Auxilliary Nurse Midwife (ANM)/ Multipurpose Workers (MPW) with support from Tuberculosis Health Visitor (TBHV)/ Senior Treatment Supervisor (STS).

Role of TS in Supply Chain Management

• Whenever a patient is initiated on treatment, the monthly patient-wise boxes are issued to the TS of the patient.
• In the case of Bedaquiline (Bdq) since the treatment is initiated at the Nodal/ District DR-TB Centre (N/DDR-TBC), on discharge, the patient is issued the remaining bottle of Bdq drug, which is then handed over to the TS.
• In the case of Delamanid (Dlm), on discharge from the N/DDR TBC the remaining drugs for the rest of the first month are issued to the patient which is then handed over to the TS.
• In any case, TS is responsible for issuing the medicines to the patient on a daily basis until the end of the course, thereby ensuring Direct Observation of Treatment (DOT).
• The TS are also responsible for collecting/ receiving month-wise boxes throughout the treatment duration of the patient.
• The TS is assigned to the Ni-kshay database with respect to the particular patient and issued a Treatment Card to maintain a record of all drugs consumed by the patient.
• In case of death/ loss to follow-up/ discontinuation of treatment due to any reason or in case of change/ modification of the regimen, the TS is responsible for returning the issued patient wise box back to the treatment centre and also ensuring that the new/modified regimen box is issued to the patient.

Resources

1. Standard Operating Procedure Manual Procurement & Supply Chain Management, CTD, MoHFW, India, 2018.
2. Procurement, Supply Chain Management & Preventive Maintenance, Module 6, CTD, MoHFW, India.
3. Direct Benefi­t Transfer Manual for National Tuberculosis Elimination Programme, Central TB Division, Ministry of Health & Family Welfare, India, 2021.

Assessment