Introduction

State Tuberculosis Training & Demonstration Centers (STDCs) are state-level strategic institutions in the National Tuberculosis Elimination Programme (NTEP). Headed by an STDC Director, it acts as the knowledge hub in the state in relation to the TB program in the state. It supports the state in Program Management by conducting its core activities of SM&E (Supervision, Monitoring and Evaluation) and Training in TB and NTEP. Apart from this it also performs some technical activities, such as, support in preparing the NTEP State PIP, implementation and scaleup of new interventions, surveillance and TB Burden estimation, conducting Operational Research, evolve the state Strategic Plan for TB Elimination and advocacy for TB Elimination efforts in the state. 

STDCs were originally established during the National TB Program (NTP), that existed before 1998, as the TDTC (Tuberculosis Demonstration and Training Centre). It was later designated as the STDC (State Tuberculosis Demonstration and Training Centre) when Revised National Tuberculosis Control Programme (RNTCP) was launched. The Terms of Reference of an STDC was last formally released in 2004. It included Training, SM&E (Supervision Monitoring and Evaluation), EQA (External Quality assurance) of sputum microscopy, Advocacy, IEC (Information, Education and Communication), and Operational research (OR) as activities. 

With the drive to accelerate progress toward TB Elimination, the NTEP has evolved and considerably expanded in-depth range of TB services. The National Strategic Plan (NSP) of the National TB Elimination Program (NTEP) envisaged the STDCs playing a significant role in building capacities of the NTEP cadres, general health system, and private health facilities/providers, along with supervision, monitoring, evaluation of the programme and operations research. With the said evolution of the TB program, the STDCs also evolved by themselves, with each state taking different approaches based on contextual need, in the absence of formal updates in the guidelines/ Terms of Reference, . 

An STDC baseline assessment was conducted (April 2021-22), through the USAID supported iDEFEAT TB Project, to evaluate and document the current status and functioning of STDCs. It was observed that there was wide variation in the capacity and functionality of STDCs in the country. There is a felt need to focus on setting up a benchmark by revising the functional framework for STDCs. 

With this context, this revision of the STDC Guidelines seeks to formally update the previous Terms of Reference (2004) to match current program operations and vision. Using the guideline, states NTEP administrators should try to align their STDC structure and functions and eventually bring uniformity in its minimum functions and performance across the country. It will also enable the NTEP leadership to evaluate the functioning of these strategic institutions and build capacity and strengthen them for optimal functioning.