Introduction

The purpose of this document is to provide the course coordinators and trainers for the ‘Course for Program Managers in NTEP’ guidance for planning and executing the training. The targeted trainees for this course would be:

  1. District Program Managers- District TB Officer (DTO)

  2. State Program Managers- State TB Officer (STO)

    This training may be provided by utilizing the blended approach where a mix of training methods and modes will be used to deliver content. This would include either in-person/ virtual training or facilitator led/ Self learning/ demonstration and role plays. Training sessions which require hands-on training will be conducted only in a physical setting. Keeping in mind the aforesaid best practices of the Modernized Training System, the training institute may decide to choose the approach which is most suitable for their trainees.

    The training of DTOs is to be conducted at National Institutes (NITRD/NTI) or at select STDCs across country as decided by Central TB Division. The training of STOs is however be conducted at the national Institutes only.

    The batch size for Physical Session/Virtual Sessions should not be more than 25.

    Virtual sessions: the trainees will be going through the online content, and attempt quizzes after each module. An instructor-led session will also be conducted for each module. This will help the trainees for better clarification of contents and to address the queries and doubts.

    Physical/In-person Sessions: For the training areas which require hand-holding of trainees like demonstration of processes- like patient management in Ni-kshay, filling of various forms, Adherence Management tools, recording information on Public Health action, use of NI-kshay Aushadhi, etc in-person training sessions need to be conducted.

    The training course content has 14 modules and 61 chapters. Based on different modalities used for the training, the training delivery should take at least 80 hours.

    For the purpose of assessment of trainees, a pre-test before the beginning of training, interim quizzes at the end of each module and a post-test at the end of training has been configured in the course content.

    Some exercises have also been formulated to assess and reinforce the learnings of the trainees based on their job requirements. These exercise will be communicated to the trainees either before the beginning of in-person sessions and the solutions of which will be discussed during the physical sessions.  
    The other exercises will be given to trainees during the conduct of the training and will be discussed simultaneously.

    The certificates are auto-generated for the trainees in their LMS account on successful completion of post-test and their performance in interim quizzes. 

    Training curriculum / Agenda

Sr. Module  Chapters Training Modality

Duration

(Hrs)
1 Basics of TB and NTEP
  • TB TB Epidemiology
  • NTEP
  • Approaches to S&M in NTEP
  • Integration of NTEP with Health System
  • Information Systems in NTEP

Self-Reading/Virtual


 

 6

2



 

 TB Laboratories and Diagnostic technologies in NTEP
  • Diagnostic Technologies and Lab Network
  • TB Detection centres
  • QA of TDC
 Self-Reading/Virtual 6 (including Lab/Field visit)
3 TB Diagnosis and Case finding
  • TB Diagnosis and Case finding
  • General Concepts in TB Case Finding
  • Specimen collection and transportation
  • Approaches to TB Case Finding
  • Diagnostic Algorithms in NTEP
  • Active Case Finding Campaign
  • S&M for Case finding activities in NTEP
 Physical

6



 
4 TB Treatment
  • Anti-TB Drug Formulations and regimens
  • ADRs to ATT
  • DS-TB Treatment and Care
  • Treatment Initiation
  • Treatment and post-treatment follow up
  • Treatment Support
  • Adherence Management
 Physical 10(including field visit)
5 TB and comorbidity management
  • National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke [NPCDCS]
  • TB and HIV
  • TB and Diabetes
  • TB and malnourishment
  • TB and Substance Abuse
  • TB and other comorbid conditions
 Physical 3  
 
6 Public Health Action
  • Patient Support
  • Contact tracing and investigation
  • Counselling
  • TB Arogya Sathi App
 Physical 4
7 TB Prevention
  • IPC
  • TPT
 Physical 4
 8 Direct Benefit Transfer in NTEP
  • General Concepts in DBT
  • Processes in DBT
  • Monitoring of DBT
 Physical

6

 
9 Financial management and Planning
  • Overview of PIP
  • Needs assessment for Planning.
  • Preparing a PIP
  • Implementing the Plan
  • Financial expenditure and accounting
 Physical 3
10 Procurement, Supply Chain Management & Preventive Maintenance
  • General Concepts in SCM
  • Information system for SCM in NTEP
  • Processes in SCM
  • Procurement in NTEP
  • QA in SCM
  Physical 6
11 Partnerships, Corporate and Multisectoral engagement
  •  General concepts in Partnership and MSE
  • Models of Partnership
  • Establishing Partnership
  • Multisectoral Engagement
  • Medical Colleges and NTEP
  Physical 4  

 

12

 

 ACSM and Community Engagement
  • ACSM
  • ACSM Activities
  • Social Inclusion and wellness activities
  • Community Engagement
  • PM TB Mukt Bharat Campaign
 Physical 4

13

 

 Supervision, Monitoring and Evaluation
  1. Supervision
  2. Monitoring
  3. Programme Reviews and Evaluation
 Physical 4
14

Training and capacity development

 Training and capacity development Physical 3

Trainers: 

For this course, personnel that have been trained and certified by Central TB Division for conducting this course at national level may only act as trainers. These may include personnel from Central TB Division, National Institutes, Technical Partner Organizations, STDCs and Medical Colleges. Central TB Division will maintain the latest list of certified trainers and need to be referred to before conducting the training.

Trainers are selected based on the following aspects

  1. Ability to conduct training in an interactive and interesting manner. 
  2. Strong knowledge about the NTEP and the various processes related to patient workflow, Ni-ksahay and Ni-kshay Aushadhi; demonstrated by completing the entire question bank related to the modules they are certified to train. 
  3. Proficient in this Chapter- wise Training Guide.
  4. Well versed with the IT systems such as, Zoom (for video conferencing), Swasth-eGurukul (Learning Management System), Ni-kshay and Ni-kshay Aushadhi.
     

Chapter wise instructions for Trainers 

The aim of providing chapter-wise detailed instructions provides the Trainers with the following:

  1. Module-wise and Chapter-wise, modality that may be adopted (Self-reading/virtual/ Physical/ In-person)
  2. The estimated time to complete the content.
  3. The key messages that a trainer should emphasize upon, while delivering the training

The activities which should be conducted at the end of each chapter / session to ensure learning effectiveness. This may include asking specific questions, demonstrating processes, discussing various forms and equipment. If any Module specific physical visits are required to be conducted, such details are also provided here. 

Some exercises have also been provided with the relevant chapters that the trainees need to finish as the part of curriculum. The trainers should ensure that all the trainees finish these exercises individually and record it in appropriate response forms. All the exercise should be discussed by the trainers during the training.

This guiding document will also aid in bringing uniformity with respect to the content and quality of training conducted across the entire state and nation. 

Module 1: Basics of TB and NTEP                                            
Chapter 1.1 TB & TB Epidemiology
Emphasis Points 1. Difference between Incidence and notification  
2. Difference between Exposure to TB, infection and TB disease.
Post Session Activity
  • Give an exercise to calculate the Notification rate of a TU. In a TU with a population of 2 lakhs, 100 TB cases were diagnosed and reported during the year 2022. A total of 90 people with TB were initiated on treatment, 5 died and  2 migrated before initiation of treatment and 3 could not be contacted at all. What is the annual TB notification rate for that TU in 2022? [ Answer: 50 per lakh]
  • Discuss - Can we call the above obtained Notification figure as the incidence of TB in that TU? If not, Why? [Discussion Points: Notification and Incidence are not the same. Notification includes all diagnosed TB cases and reported to the system. It includes both new and previously treated cases. There may be cases diagnosed, but not reported. It is possible that there will be cases in the community not diagnosed at all.]

These exercises are to be given as assignments that trainees need to finish before start of 2nd module.

Assignments:

  1. Find the incidence of TB in India in preceding year. Please mention the source . 
  2. What was the no of TB notifications in India for year 2021. Please mention the source
  3. Why incidence is not same as notification?  
  4. Download the notification register (Q1-2023) of your district.   
    1. What are the Columns headings available in the register?  
    2. What are the options available under the filters for the 4 columns- a) patient status, b) key population, c)basisOfDiagnosis_FinalInterpretation, d) Treatment Outcome
Chapter 1.2 NTEP
Emphasis Points
  1. Explain what India is committed to achieve in 2025 in relation to SDG related to ending TB. Clarify that the country has preponed the 2030 SDG targets related to ending TB to 2025.
  2. Organizational structure of NTEP with broad functions of each institution (state level and below) 
  3. Different stages in the patient’s life cycle need to be explained in detail and emphasis on the concept of continuum of care from ‘presumptive TB to post treatment follow up'.
  4. Concepts of ‘’Standards of TB Care’’ as a minimum set of care that every citizen in India should receive irrespective of where he/she seeks care from.
  5. What does a TU actually mean? 
Post Session Activity

Discuss- ‘What India is committed to achieve in 2025 in relation to ending TB?’’ [Clarify that the country is only trying to achieve the SDG goals related to Ending TB]

Discuss- ‘Can Medical College/ IRL be a PHI?’[Clarify that any patient service delivery point will be a PHI, but program management units like STC, DTC, TU etc are not PHIs]

Assignments:

  1. Enumerate the 4 pillars/strategies mentioned in NSP (2017-2025).
  2. Elaborate the build component with respect to your district.
Chapter 1.3 Approaches to S&M in NTEP
Emphasis Points Discuss the importance of S&M. Emphasize that S&M of the different activities under NTEP will be discussed alongside the activity while discussing the content in the modules.
Post-session activity

Assignment:

1.3.1- Find the index score of your district using Nikshay for year 2022.  
1.3.2.-FInd the areas where the performance of district is less than the state average.
Chapter 1.4 Integration of NTEP with Health System
Emphasis Points Discuss the need for integration of NTEP with the general health system & NHM and how that integration is envisioned.
Post-session activity

Discuss - "What are the opportunities available to NTEP through Health & Wellness Centers? How could that be materialized?

Assignments: 

1.4.1-Write the organisation str of NTEP in your district.  
1.4.2-Draw the district health system structure and how NTEP is integrated into it.
Chapter 1.5 Information Systems in NTEP
Emphasis Points
  1. The Information system in NTEP is an ecosystem of three applications (Ni-kshay, Ni-kshay Aushadhi and Ni-kshay LIMS ) which interact with each other and with other external systems.
  2. Data from these systems may be viewed/ extracted for monitoring and review purposes from Ni-kshay Reports and Dashboards.
  3. Patients may access their health record from the Ni-kshay Arogya Saathi Application
  4. There may be other additional supporting applications provided by NTEP, states, National Institutes  or by other partner organizations. Eg, TB Free Himachal, N-TB Application, ManageTBIndia, 
Post-session Activity 1.5.1- Enlist the different stakeholders that are working with Nikshay and their specific roles in NI-kshay.
Module 2 TB Laboratories and Diagnostic technologies in NTEP
Chapter 2.1 Diagnostic Technologies and Lab Network
Emphasis Points Names of different tests, their uses, advantages and disadvantages
Post-session Activity

Discuss: what are the advantages and disadvantages of FL- LPA over NAAT? 

Discuss “how many sputum collection and transportation facilities are there in their concerned district? Make one participant explain how it functions and what are the benefits out of it”? - Bring out the following benefits (1) prevents leaks in cascade of care (reduce loss from presumptive TB identification to TB Testing) (2) minimizes patient inconveniences (3) minimize patient Turnaround Time (4) reduce out of pocket expenditure (5) helps in infection control as people with symptoms need not travel

Assignment:

3.1.1Learn about the processes being followed in your district for sample transport from patient to TDC.  
3.1.2Learn about the different processes being followed in Nikshay for the same- i.e. adding test request, sample details and entering results in Ni-kshay.
Chapter 2.2 TB detection Centres
Emphasis Points Discuss the consumables required for the Microscopy, CBNAAT and Truenat
Post-session Activity

Assignments:

A Lab-visit needs to be organised for participants to see the different processes involved for testing.
Chapter 2.3 Specimen collection and transportation
Emphasis Points

The need for SCT, importance of cool chain requirement.

Discuss how the delays can be reduced to improve the TAT overall
Post Session Activity May ask one of the participants to volunteer and demonstrate the different processes being followed in Nikshay for the same- i.e. adding test request, sample details and result updation in Ni-kshay.
Chapter 2.4 Quality Assurance of TDC
Emphasis Points Explain the process involved in EQA of microscopy.
Post-session Activity

Lab Field visit:

A field visit should be organized to a lab to understand and discuss the following:

  1. Microscopy Centre:  The following should be discussed/ demonstrated:
    1. Slide preparation, Storage of slides  
    2. Lab Register (Physical and Ni-kshay: what all records are being digitized) 
    3. Selection of slides for EQA & RBRC  
    4. Quality Control (QC) slides  
    5. Flow of pt and samples from OPD to MC and to CBAAT facility.
    6. View the "My tests" page of the PHI login in Ni-kshay and review the status of tests in the last 1 month. 
    7. Discuss the process of referring a patient for testing through Ni-kshay. 
  2. NAAT Facility
    1. Discuss the CBNAAT process overview  
    2. DOs and Don'ts while doing CBNAAT  
    3. View the "My tests" page of the PHI login in Ni-kshay and review the status of tests in the last 1 month. 

3) Obtain the Lab register from Nikshay and calculate the patient TurnAroundTime (referral to test reporting) for the lab and compare it with the Lab TurnAroundTime (Sample Receipt to Reporting)
Module 3

TB Diagnosis and Case finding
Chapter 3.1 General Concepts in TB Case Finding
Emphasis Points Differentiate between screening and testing. 
Post-session Activity  
Chapter 3.2 Approaches to TB Case Finding
Emphasis Points Clearly differentiate the difference between the three different approaches- Active, Passive and Intensified.
Post-session Activity
  • Discuss the following scenarios and ask the participants which case finding those are

(i) Screening for active TB in a Diabetic Clinic & testing those who screened positive

(ii) Screening for active TB in an elderly home & testing those who screened positive

(iii) Screening for active TB in cancer wards & testing those who screened positive
Chapter 3.3 Diagnostic Algorithms in NTEP
Emphasis Points Discuss how the algorithms to be read
Post-session Activity Ask the participants to look at details of 5 TB patients from their district and see whether complete diagnostic algo has been followed or not.
Chapter 3.4 Active Case Finding Campaign
Emphasis Points Step by step process in planning and execution of an ACF campaign with special emphasis on identification of target population, need for micro planning and need to prevent the leaks in the cascade of care.
Post-session Activity Discuss how ACF campaign is carried in participants district and how the activity can be carried out more effectively.
Chapter 3.5 S&M for Case finding activities in NTEP.
Emphasis Points Discuss the TB index dashboard.  
Discuss the TB Notification dashboard,
Post-session Activity The participants may be asked to access the TB index dashboard and TB notification dashboard from their logins and share their learnings with other audience.
Module 4 TB Treatment
Chapter 4.1 General Concepts in TB Treatment
Emphasis Points

It's an overview chapter explaining the concepts- Fixed Dose Combination, Intensive & Continuation Phase.  

  • Process of Treatment Initiation and Transfer of patients 
  • Follow-up - clinical and laboratory, assigning Treatment outcome and long-term follow-up.
Post-session Activity Request two participants to demonstrate in Demo Ni-kshay the ‘Transfer’ of patients using (i) Push and (ii) Pull methods. 
Chapter 4.2 ADRs to ATT
Emphasis Points Discuss about the aDSM available in Ni-kshay , the importance and how it is carried out.
Post-session Activity Ask one of the participants to demonstrate the adverse event module in Ni-kshay from reporting, management and outcome.
Chapter 4.3 DS-TB Treatment and Care
Emphasis Points
  • Regimen and dose of drugs for managing DS-TB for adults and paediatric group and weight bands available. 
  • Display all FDCs in NTEP and ensure the participants could identify all information related to it.
  • Common adverse events of anti-TB drugs
Post-session Activity
  • Call one participant and ask to explain the step-by-step process for initiating treatment to a 50 Kg old adult diagnosed with pulmonary TB (Rif Sensitive). Write down all the steps in a flip chart/chatbox/Virtual whiteboard. Ask other members to comment on the missed steps and the order of steps. 
  • Call a second participant and ask to explain the follow up for the same patient.
Chapter 4.4 Overview of DR-TB 
Emphasis Points

Explain: 

  • What is UDST?
  • Classification of DR-TB?
  • Regimens available for DR-TB?
  • Levels of facilities where treatment needs to be initiated.
Post-session Activity Ask participants for doubts and help them clear those doubts. 
Chapter 4.5 Isoniazid [H] Mono/Poly DR-TB Regimen
Emphasis Points Discuss the regimen composition and duration, inclusion-exclusion criterion, replacement sequence and the follow-up examination.
Post-session Activity May ask the participant to look at 2 TB patients (outcome declared) on H Mono/poly DR-TB regimen whether the follow-up sputum examination was done timely or not.
Chapter Shorter Oral Bedaquiline-containing MDR/RR-TB Regimen
Emphasis Points Discuss the regimen composition and duration, inclusion-exclusion criterion, replacement sequence and the follow-up examination.
Post-session activity May ask participants to look at 2 TB patients (outcome declared) on shorter oral Bdq containing MDR/RR regimen whether all the relevant investigations for PTE and follow-up sputum examination were carried out timely.
Chapter Longer Oral M/XDR-TB Regimen
Emphasis Points Discuss the regimen composition and duration, inclusion-exclusion criterion, replacement sequence and the follow-up examination.
Post-session activity May ask participants to look at 1 TB patient (outcome declared) on longer oral M/XDR regimen whether all the relevant investigations for PTE and follow-up sputum examination were carried out timely.
Chapter 4.6 Treatment Support
Emphasis Points Discuss the role of treatment supporter and how they can be registered in Nikshay, patient mapped. 
Post-session Activity Ask the participants to practice the registration of treatment supporter and subsequent mapping of patients to the treatment supporters in demo-version in Ni-kshay.
Chapter 4.7 Adherence Management
Emphasis Points
  • Discuss about the importance of adherence and how adherence is being reported, recorded and monitored through Ni-skahy.
  • Imparting skills to Record adherence in Ni-kshay- Demonstrate the recording of adherence in Ni-kshay. 
  • Recording adherence using TB Arogya Sathi Application  
    Discuss about the Adherence dashboard.
Post-session Activity
  • One/more participants may be asked to record the adherence in Ni-kshay
  • Request everybody to open their adherence dashboards and comment on their % of 'Average Adherence' of all patients on treatment.
  • Request all participants to open their adherence task list and ask their plans based on the task list
Chapter Monitoring of Treatment
Emphasis Points Discuss the indicators used in monitoring the treatment- treatment initiation, outcome declaration.
Post-session activity

Exercise: Ask the participants to download the notification register for Q1-2023 and ask them to calculate the average delay in treatment initiation from date of diagnosis.

Discuss how this delay can be minimised.
Field Activity

A 2nd field visit(Batch size- 5-7 participants) should be organised to the following

  1. Treatment Centre (PHI)
    1. Explain Patient flow at the centre: OPD visit (passive case finding) - registration/enrolment-> Visit to MO-> Specimen collection and transportation (spot and early morning samples) -> Pre-treatment counselling->Treatment initiation-> Dispensation-> Home visits->ADR identification and reporting-> Follow-up patient visits -> transfer of patient. The data entry points for recording the above processes in Ni-kshay and the relevant forms and registers to be maintained at the treatment centres.
  2. District Drug Store
    1. Discuss storage of drugs(ideal storage conditions),
    2. Processes being followed at DDS (inward and outward stocks) - Both physical and Ni-kshay Aushadhi Records and registers (including logbook for temp and humidity, Stock Registers, Intend/ Drug Request form, maintained at DDS
  3. DR-TB centre/ward
    1. Interview with the 1-2 patients and understand their journey from exposure to TB to current day.
    2. Pre-treatment evaluation processes
    3. Review and fill the checklist for DR-TB centre (Annex 22, PMDT guidelines 2021)
    4. The DR-TB committee meeting records
    5. The checklist for DR-TB wards
Module 5

TB and comorbidity management
Chapter 5.1 TB and HIV
Emphasis Points Bidirectional screening for TB-HIV
Post-session activity Ask the participants to describe the existing mechanism at their district to screen TB among the people visiting ICTC centres-  
how is the screening being done? How is it ensured that all those referred for testing have undergone testing? Discuss if there is any scope for improvement.
Chapter 5.2 TB and Diabetes
Emphasis Points Bidirectional screening for TB-Diabetes
Post-session activity Ask the participant to describe how diabetes testing is done among people with TB in their district? What are the steps if a person with TB is found to have diabetes? Who and how is diabetic control ensured for that person? Discuss if there are any ways to improve. 
Chapter TB and malnourishment
Emphasis Point: Discuss how malnourishment affects TB patient and role of Nutritional support in successful completion of treatment.
Chapter TB and Substance Abuse
Emphasis Point:  Discuss how Alcohol and Tobacco Abuse affects TB and importance of linkage with the deaddiction centre. 
Post Session Activity The participants may be asked to list the de-addiction centres and tobacco-caseation centres.
Chapter TB and other comorbid conditions
   
Module 6 Public Health Action
Chapter 6.1 Patient Support
Emphasis Points Various kinds of support the TB patient needs (nutritional support, psychosocial support, support for deaddiction, travel support) and how STS could help in offering the same 
Post-session activity Give a scenario: A 62 year old woman from a Tribal community affected with TB. Ask all participants to list out all the Government schemes/initiatives which can support her during the treatment period? Write down all schemes in a flip chart/Chatbox/Virtual board 
Chapter 6.2  Contact tracing and investigation.
Emphasis Points

Discuss:

  • Step by step process for contact investigations
  • Discuss the steps to record the contact tracing in Ni-kshay
Post-session Activity
  • Ask one of the participants how contact investigations are happening in his/her district (Coverage, Quality, Periodicity, Challenges).  
  • Ask one/more participants to demonstrate the process in Ni-kshay(Demo) 
Chapter 6.3 Counselling
Emphasis Points

Discuss:

  • Basic principles of counselling (DOs and DONTs)
  • Points to be included while counselling of a person with TB
Post-session Activity
  • Ask participants to comment on the following statements made by STS while counselling a person with TB
  1. “I have already informed all people who came to your shop that you are having TB”. (Clue: It's a breach of confidentiality. It should have been discussed with the person with TB first. The person with TB should have been empowered to disclose it to others if required)
  2. “If you are not taking the medicines properly, you will definitely die”. (Clue: It's a coercive/threatening language and should be avoided)
  3. “Because you were a smoker and alcoholic, you got TB” (Clue: It's a blame on the person and should be avoided)
Chapter 6.4 TB Arogya Sathi App
Emphasis Points

Discuss the various information available in TB Arogya Sathi Application- 

  • the two user interfaces (General Public and TB patient)
  • The TB Screening tool
  • How to locate the nearest health facility
  • Accessing the treatment details (patient interface)
  • Recording the adherence using the app
  • Viewing the DBT benefits and statuses.
  • Entering /modifying the bank details
Post-session Activity The participants may be requested to do a screening test on themselves and check the working of the application.
Module 7 TB Prevention
Chapter 7.1 Infection Prevention and Control
Emphasis Points

Discuss the following:

  • Need for IPC
  • Airborne infection control and need for it.
  • Administrative measures for ensuring AIC (particularly with respect to HFs). 
  • Ventilation as an AIC measure (focus on seating plan for Health care provider and people with symptoms, air-flow in labs providing TB detection/diagnostic servies)
  • AIC practiced at Microscopy centres including the PPEs
  • The need and ways for disinfection and Bio-medical waste management at the Health facilities
  • the important roles various stakeholders are required to play emphasising more on their role.
Post-session Activity
  • May ask the participants to recollect the AIC practices being followed in DR-TB ward (part of field-visit) and enumerate it.
Chapter 7.2 TB Preventive Treatment
Emphasis Points

Discuss the following points:

  • The eligibility for TPT
  • The different regimens available
  • The different approaches- Test & Treat and test only approach.
  • Testing for TB infection- TST, IGRA and CyTB and interpretation of different test results
  • Counselling for TBI testing and TPT
  • Importance of adherence for TPT and its monitoring
  • Management of missed doses in TPT course
  • Outcome for TPT t
  • Monitoring indicators for TPT
Post-session Activity Ask the participants to download the Contact tracing register (for Q3-2022) and comment on the leakages in the cascade of care for TPT for your district. 
Chapter 8.1 General Concepts in DBT
Emphasis Points

Discuss the following points:

  • Different DBT schemes under NTEP- beneficiaries and benefits
  • Different stakeholders for DBT and their roles & responsibilities
  • Other state-specific social welfare schemes may also be discussed
  • Ni-kshay Poshan Yojana- benefit and the eligibility conditions
  • Tribal Support scheme
  • Treatment Supporter- eligibility and Honorarium
  • Financial incentives for Private provider and informants
  • How to register the private Health facilities and processing of their benefits
  • Discuss the generation of benefits in Ni-kshay
  • Different scenerios where private facilities will be getting benfits
Post-session Activity  
Chapter 8.2 Processes in DBT
Emphasis Points

Discuss the following points:

  • Process of benefit processing in Ni-kshay
  • Steps that need to be taken by DBT maker at TU level
  • Steps that need to be taken by DBT checker at Distrcit level
  • Process flow for DBT in PFMS
  • Benefit processing and approval in PFMS
  • Process to create DBT maker and checker accounts.
Post-session Activity  
Chapter 8.3 Monitoring of DBT
Emphasis Points

Discuss the following points:

  • the different registers- Benefit register, beneficiary register, benefit batch register.
  • DBT troubleshooting at various levels- Beneficiary, Benefit, Maker, Banking, PFMS
  • DBT dashboards
  • DBT process Indicator dashboards
Post-session Activity
  • Ask the participants to open the dashboard for their particular district: and look at the information available in the funnel diagram. (Scheme: NPY and Notification cohort- previous two quarters)- Identify the level at which the delay is maximum and discuss what measures can be taken to reduce the delay). Ak them to try the beneficiary status and benefit status. The geographic view may also be discussed to assess the TU wise performance.
  • May ask the participants to do the same exercise for other DBT schemes and ask them to explore the reasons. 
  • The participants may be asked to open the DBT process Indicators dashboard for their district and explore the different schemes and discuss the insights developed during the process.
Module Financial management and Planning
Chapter 9.1 Overview of PIP
Emphasis Points

Discuss the following points:

  • the general terms related to PIP
  • The fund flow 
  • Role of DTO in PIP preparation
Post-session Activity May ask the participants for any doubts/queries.
Chapter 9.2 Needs assessment for Planning
Emphasis Points

Discuss the following points:

  • Identifying the gaps in known program indicators
  • Needs assessment
Post-session Activity May ask the participants to clear their doubts
Chapter 9.3 Preparing a PIP and Implementing the plan
Emphasis Points  
Post-session activity May give one PIP format to the participants and ask them to fill it for their district.
Chapter 9.4 Financial expenditure and accounting
Emphasis Points

Explain the following.

  • The general principles of accounting
  • Basics of account books and records and the maintenance
  • Issue and receipt of vouchers
  • Financial Audits
Post-session Activity  
Module Procurement, Supply Chain Management & Preventive Maintenance
Chapter General Concepts in SCM
Emphasis Points

Explain the following concepts:

  • Drug distribution flow
  • Different stock types and its importance
  • FEFO and its importance
  • Different drugs and supplies under NTEP
  • various stocking points in NTEP
  • Drug stores at different levels- SDS, DDS, TU drug store and drug storage at PHI level (how drugs are stored and role of different stakeholders)
  • Flow of different drugs in NTEP- DS-TB, DR-TB, Bdq, Dlm, Lab supplies.
  • Expiry management and monitoring.
Post-session Activity  
Chapter Information system for SCM in NTEP
Emphasis Points

Discuss the following:

Ni-kshay Aushadhi

Different dashboards- State/district/Alert/Reports and features available at different levels.
Post-session Activity Ask the participants to open their district dashboard and look at the alert dashboard and share the finding with other participants.
Chapter Processes in NTEP
Emphasis Points

Discuss and demonstrate the participants the following processes:

  • Indenting meaning and procedure for requesting the supplies from different levels
  • Issue of supplies and recording in Ni-kshay Aushadhi
  • Consumption of supplies at different levels
  • Forecasting- meaning, importance and calculations.
  • Expiry of drugs, forecasting and disposal
  • PWB- types and preparation
  • Process of return of drugs
  • Reconstitution of Bdq bottle and recording in Ni-kshay
Post-session Activity

Ask the participant to demonstrate the following in demo version of Ni-kshay AUshadhi:

  • Indenting of drugs from the TU store to district
  • Issue of supplies to TU from the district
  • Acknowledge the receipt of drugs at TU
  • Dispatching of drugs in Ni-kshay Aushadhi: On request and without request

 

Ask the participants to demonstrate the following in demo version of Nikshay

  • Adding and Printing Dispensation
  • Returning the dispensation

 

Ask the participants to forecast the supplies (for DS-TB drugs) for next quarter on the basis of consumptions based in previous quarter in their district

 

 

 
Chapter Procurement in NTEP
Emphasis Points

Explain the following points:

Procurement- meaning and importance.

Different types of procurement processes- Direct and tendering

Government e-Marketplace - meaning and different processes involved.
Post-session Activity The trainer may demonstrate them the processes involved in GeM using the demo version/live version using their login credentials. 
Chapter Quality Assurance in Supply Chain Management
Emphasis Points

Discuss the following points: 

Meaning and Processes involved in QA of drugs in NTEP

Recording of QA of drugs in Ni-kshay AUshadhi

Monitoring of drug stores 

Store visits in NTEP- checklist for store visits

Physical verification of supplies and recording in Ni-kshay Aushadhi
Post-session Activity Ask the participant to open demo Ni-kshay aushadhi and demonstrate the recording of Physical Stock verification, and QA of drugs
Module Partnerships, Corporate and Multisectoral engagement
Chapter 10.1 General Concepts in Partnership and MSE
Emphasis Points

Discuss the following points:

  • Vision of NTEP regarding private sector Engagement
  • Importance of Private Sector Engagement and multisectoral engagement
  • Stakeholders for Private Sector Engagement
  • Steps for Engagement.
  • Involvement of Pharmacist, Labs, Ayush Providers
  • Regulatory provisions- H1 regulation, Mandatory notification
Post-session activity  
Chapter 10.2 Models of Partnerships
Emphasis Points

Discuss the following-

  • STEPS
  • PPSA
  • Direct Engagement
Post session activity. May ask the participants to clear their doubts.
Chapter 10.3 Establishing the partnerships
Emphasis Points

Discuss the following:

Guidance Document on Partnership- Overview

Undertaking a needs assessment

Mapping of the stakeholders- meaning and process

Partnership Options- meaning and significance.

Steps to engage a service delivery.

Partnership options available to Private sector engagement

Bundling approach- meaning and significance

Contract- Meaning, Types: input-based, Output-based, Fee for service contract,

Steps for executing a contract.

Budgeting for Partnership options

Performance matrix for partnerships

Verification and validation of invoices
Post Session activity The participants may clear their doubts.
  Multisectoral Engagement