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IEC-M4: Advocacy, Communication & Social Mobilization (ACSM)

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  3. IEC-M4: Advocacy, Communication & Social Mobilization (ACSM)
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  • IEC-CH13: Concepts in ACSM

    Fullscreen
    • What is A in ACSM

      Content

      In ACSM, "A" stands for Advocacy. "Advocacy" is an activity by an individual or a group that aims to influence the decisions within political, economic and social institutions. 

      Advocacy focuses on influencing policy-makers, funders and international decision-making bodies through a variety of channels:

      • Conferences, summits and symposia
      • Celebrity spokespeople, press conferences, news coverage
      • Meetings between various levels of government and civil society organizations
      • Official Memoranda of Understanding (MoU), parliamentary debates and other political events
      • Partnership meetings, patients’ organizations, private physicians, radio and television talk shows, and service providers.

      Types of advocacy

      • Policy advocacy: Mainly targets policy-setting, influencing policymakers to incorporate the latest evidence and informs senior politicians and administrators how an issue will affect the country, and outlines actions to take for improving the laws and policies.
      • Programme advocacy: Targets opinion leaders at the community level on the need for local action.
      • Media advocacy: Validates the relevance of a subject, puts issues on the public agenda and encourages the media to cover TB-related topics regularly and in a responsible manner so as to raise awareness of possible solutions and problems.

       

      Resources

      1. Advocacy, Communication & Social Mobilization (ACSM) for Tuberculosis Control - A Handbook for Country Programmes, WHO, 2007.
      2. Operational Handbook on Advocacy, Communication & Social Mobilization for RNTCP, Central TB Division, MoHFW, GoI, 2014.

       

       

      Assessment:

      Question​

      Answer 1​

      Answer 2​

      Answer 3​

      Answer 4​

      Correct answer​

      Correct explanation​

      Page id​

      Part of Pre-test​

      Part of Post-test​

      News reports on World TB day celebrations are an example of which of the following types of advocacy?

      Policy advocacy

      Programme advocacy

      Media advocacy

      None of the above

      3

      Media advocacy encourages the media to cover TB-related topics regularly and in a responsible manner so as to raise awareness of possible solutions and problems.

       

      ​

      Yes Yes
    • What is C in ACSM

      Content

      Communication aims to favourably change knowledge, attitudes and practices among various groups of people. 

      Types of communication in healthcare are:

      • Oral/verbal communication- by word of mouth (speech/talk)
      • Written communication- exchange of facts, ideas and opinions through the use of written materials
      • Non verbal communication- through gestures, body language or posture, facial expressions, and eye contact 
      • Visual communication- exchange of ideas through visuals

      Health communication aims to influence and empower individuals, populations and communities to make healthier choices. It frequently informs the public of the services that exist for diagnosis and treatment and relays a series of messages about the disease. It aims to inculcate behaviour change for healthy life choices.

      E.g.: “Seek treatment if you have a cough for more than two weeks”, “TB hurts your lungs” or “TB is curable”.

      Approaches to health communication

      1. Informative communication

      Provides information about a new idea and makes it familiar to people.

      2.Educative communication

      A new idea on health behaviour is explained, including its strengths and weaknesses.

      3.Persuasive communication 

      Usually in the form of a message that promotes a positive change in behaviour and attitudes, and which encourages that audience to accept the new idea. This approach to message development involves finding out what most appeals to a particular audience. Persuasive approaches are more effective than coercive approaches in achieving behaviour change.

      4.Prompting communication

      Messages are designed so that they are not easily ignored or forgotten they can be used to remind the audience about something that reinforces earlier messages.  

      Behaviour Change Communication (BCC)

      • Behaviour Change Communication (BCC) is an interactive process of any intervention with individuals, groups or communities to develop communication strategies to promote positive health behaviours which are appropriate to the current social conditions and thereby help the society to solve their pressing health problems.
      • BCC creates an environment through which the affected communities can discuss, debate, organize and communicate their own perspectives on TB.
      • It aims to change behaviour – such as persuading people with symptoms to seek treatment – and to foster social change, supporting processes in the community or elsewhere to spark a debate that may shift social mores and/or eliminate barriers to new behaviour.

       

                                                                                                 Figure: Behaviour Change Communication

       

       

       

      Resources

      1. Advocacy, Communication & Social Mobilisation (ACSM) for Tuberculosis Control - A Handbook for Country Programmes, WHO, 2007.
      2. Operational Handbook on Advocacy, Communication & Social Mobilisation for RNTCP, Central TB Division, MoHFW, GoI, 2014.

       

       

       

      Assessment:

      Question​

      Answer 1​

      Answer 2​

      Answer 3​

      Answer 4​

      Correct answer​

      Correct explanation​

      Page id​

      Part of Pre-test​

      Part of Post-test​

      What does the environment created by behaviour change communication encourage the TB-affected communities to do?

      Discuss, debate, organize, communicate

      Discuss, organize, implement, communicate

      Organize, enforce, communicate

      None of the above

      1

      Behaviour change communication creates an environment through which the affected communities can discuss, debate, organize and communicate their own perspectives on TB.

       

      ​

         
    • What is SM in ACSM

      Content

      Social Mobilisation (SM) is the process of bringing together different stakeholders and building partnerships to prevent, detect and cure TB. It generates dialogue, negotiation and consensus among a range of players that includes decision-makers, the media, Non-government Organisations (NGOs), opinion leaders, policy-makers, the private sector, professional associations, TB-patient networks and religious groups.

      At the heart of social mobilisation is the need to involve people who are either living with active TB or have suffered from it at some time in the past.

       

      Aims of Social Mobilisation

      • Increase awareness of the disease (TB) and the demand for diagnosis and treatment services

      • Expand service delivery through community-based approaches

      • Enhance sustainability, accountability and community ownership of TB services

       

      Activities for Social Mobilisation

      • Group and community meetings - Engaging yuva/ mahila mandals, village health sanitation and nutrition committees under the National Rural Health Mission (NRHM), sensitization of local and religious leaders on TB and related stigma in the community. Regular meetings at the village level to address myths and misconceptions and help people with TB symptoms seek timely and appropriate care or referrals.
      • School activities - Conducting TB awareness campaigns in schools by addressing the school assembly/ class, painting competitions, rallies, road shows, essay competitions, drawing competitions, exhibitions, dramas, pictorial presentations, quizzes, puzzles, puppet shows, leaflet distributions etc.
      • Traditional media group performances - Performing entertainment-centred folk performances, street plays with scripts centred around TB awareness messages.
      • Rallies and road shows - Spreading TB related messages on World TB day.
      • Home visits - Encouraging interpersonal communication and empowering former TB patients and TB champions to become Directly Observed Treatment, Short-course (DOTS) providers.

      Here, inter-personal communication and group communication are the main channels of communication for disseminating TB-related key messages.

       

      In the National TB Elimination Programme (NTEP), partner NGOs play an important role in social/ community mobilisation. It generates dialogue, negotiation and consensus, engaging a range of players in interrelated and complementary efforts while taking into account people’s needs.

       

      Resources

       

      1. Advocacy,Communication & Social Mobilisation (ACSM) for Tuberculosis Control - A Handbook for Country Programmes, WHO, 2007.
      2. Operational Handbook on Advocacy, Communication & Social Mobilisation for RNTCP, Central TB Division, MoHFW, GoI, 2014.

       

      Assessment:

      Question​

      Answer 1​

      Answer 2​

      Answer 3​

      Answer 4​

      Correct answer​

      Correct explanation​

      Page id​

      Part of Pre-test​

      Part of Post-test​

      A roadshow was conducted by local PHC in a village on World TB day with message to End TB. This is an example of:

      Policy making

      Social mobilisation

      Institutional strengthening

      Diagnostics

      2

      Roadshow is one of the activities of social mobilisation strategy which aims at increasing awareness about the disease, involving major stakeholders.

      ​

         

       

       

       

       

       

  • IEC-CH14: Guidelines & protocols for ACSM Activities

    Fullscreen
    • Organising Community meetings

      Content

      Community meetings are organised by the Senior Treatment Supervisor (STS) or the partner Non-Government Organisation (NGO) under the supervision of the Medical Officer.

      • These meetings are conducted to create awareness about TB among the general population, community leaders, people’s representatives, Self-help Groups (SHGs), community volunteers, traditional healers, etc.
      • These meetings are organised in a community centre or any other suitable place at the village and slum level.
      • To maximise the output, the community meetings should be planned appropriately.

      Following are the steps involved in planning a community meeting:

      Image
      Community meeting steps

       

      Resources

      • Operational Handbook on Advocacy, Communication and Social Mobilisation (ACSM) for RNTCP, Central TB Division, Ministry of Health and Family Welfare.

       

      Assessment

       

      Question​ Answer 1​ Answer 2​ Answer 3​ Answer 4​ Correct answer​ Correct explanation​ Page id​ Part of Pre-test​ Part of Post-test​
      Who supervises the conduct of community meetings? DTO STO MO STLS 3 Community meetings are organised by the STS or the partner NGO under the supervision of the Medical Officer.   YES YES
    • Peer group interventions

      Content

       

      Community or peer-led measures penetrate better into the intricate layers of key population and facilitate Intensive Case Finding (ICF). Peer group support helps patients deal with challenges that they face during the treatment period. Several Tuberculosis (TB) patients find their treatment period stressful and having a peer to talk to, who has undergone similar challenges, and a doctor or counsellor to answer their questions, helps build confidence and realization that they are not alone in this journey.

       

      Image
      Peer group characteristics

       

      Figure 1: Characteristics of a Peer Group

       

       

      Image
      Influence of peer group on TB patients

       

      Figure 2: Peer group interventions has an influence on the knowledge, attitude, and quality of life of the pulmonary tuberculosis patients

       

      • Peer group intervention is human centered approach as it involves perspectives from the patients and their care givers encouraging them to openly discuss their concerns. Peer group intervention builds collective strength and solidarity among patients attending the group meeting and improve their treatment experience by learning from experience of peers. Talking to others in support groups reduces anxiety, improves self-esteem, and helps members' sense of well-being overall.

       

      • Peers are an underused resource for strengthening TB control among socially excluded populations. There is a need for further research into the contribution of peers to TB control, including analyses of economic effectiveness.

       

       

      Peer group interventions for TB patients are:

       

      • Conducting patient support group meetings where patients and care givers can discuss their concerns and invite other patients who have addressed similar issues in their treatment. Social support from family and friends, helps in patient’s adherence to treatment. Treatment adherence is a key to the completion of TB treatment. The support is part of an external stimulus which can develop a particular behavior in human.

       

      • Peer group members can facilitate linkages to nutrition and other forms of support for TB patients – Patients or caregivers can be linked to support services like counselling, nutrition and social entitlements, either from the NTEP or through other public schemes or community structures.

       

      • Peer group members can help each other by sharing their knowledge to create linkages with the medical support systems – TB patients who develop side effects due to medication, should be linked for medical support during the meetings. Medical Doctor/STS/TBHV/CHO shall provide counselling to patients regarding side effects of the TB treatment and how to address the issues. Members act as role models for each other. Seeing others who are contending with the same adversity and making progress in their lives is inspiring and encouraging.

       

      • Peer group members can facilitate interactions of family members with Medical officer (M.O.)/National TB Elimination Programme  (NTEP) staff – Peer group meetings can be used to counsel the caregivers on how to take care of the patient at home. A support group is a safe place for someone who needs to talk about intensely personal issues, experiences, struggles, and thoughts.

       

       

       

      Resources

       

      Guidance document on community engagement under NTEP Central TB Division, MoHFW, GoI September 2021

       

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

       

      NTEP Training Modules 5 to 9, Central TB Division, MoHFW, GoI 2020

       

       

      Assessment

       

        Question    

      Answer  

      1    

      Answer 2    

      Answer 3    

      Answer 4    

      Correct answer    

      Correct explanation    

      Peers are an underused resource for strengthening TB control among socially excluded populations. There is a need for further research into the contribution of peers to TB control, including analyses of economic effectiveness.

       

       

       True 

        False

         

         

       1

      Community or peer-led measures penetrate better into the intricate layers of key population and facilitate Intensive Case Finding (ICF).

       

       

       

       

       

    • ACSM activities in schools

      Content

      In order to create awareness and mobilise young students to fight against TB, the National TB Elimination Programme (NTEP) encourages TB awareness campaigns in schools.

      Common school activities undertaken to create awareness about TB among children include the following:

      • Addressing the school assembly/ classes
      • Holding painting competitions
      • Holding rallies and road shows
      • Holding essay competitions
      • Holding slogan competitions
      • Reading TB leaflets during prayers
      • Organising quizzes
      • Puzzle games
      • Pictorial presentations (presenting TB-related information in the form of pictures)
      • Organising exhibitions (posters, models etc.)
      • Katputli shows
      • Distributing leaflets containing information about TB

       

      Steps for Organising School Activities

      School activities could prove very effective, provided they are well planned. Following are the steps for effective organisation of school activities:

      Image
      Steps for Organising School Activities

       

       

      Resources

      • Operational Handbook on Advocacy, Communication and Social Mobilisation (ACSM) for RNTCP. Central TB Division, Ministry of Health and Family Welfare.

      Assessment

      Question​

      Answer 1​

      Answer 2​

      Answer 3​

      Answer 4​

      Correct answer​

      Correct explanation​

      Page id​

      Part of Pre-test​

      Part of Post-test​

      Training school teachers is a part of the ACSM activities in schools. True

      False

       

       

      1

      Training of school teachers, who will in turn conduct school activities in a planned manner is a part of ACSM activities in schools.

       

      YES

      YES

       

    • Community mobilization strategies-Tribal areas

      Content

      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:

       

      Image
      Community mobilization strategies in tribal areas

       

      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.
      Image
      Interdepartmental Collaborations

       

       

      1. Coordination with ‘Centre of Excellence’ within the Ministry of Tribal Affairs, with a key focus on TB.
      2. Partnering with private sector players for leveraging resources for TB elimination in Tribal communities.
      3. Documenting best practices, and commission tribal health research studies in collaborations with identified government institutions.
      4. 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

       

      Question    

      Answer  

      1    

      Answer 2     Answer 3     Answer 4     Correct answer     Correct explanation    
      Community mobilization strategies in tribal areas include home visits.  True    False      1

      Community mobilization is about seeking cooperation and support from different stakeholders in general and the community in specific.

      Home visits will improve awareness on various government schemes, provisions, facilities available for TB patients and to improve treatment literacy and adherence among TB patients in tribal areas.

       

       

       

       

       

       

    • Community mobilization strategies-Rural areas

      Content

       

      Rural populations have more limited access to primary care physicians than residents of urban areas, and are older, sicker, and poorer than urban counterparts. Travel to reach a primary care provider may be costly and burdensome for patients living in remote rural areas, with subspecialty care often being even farther away. These patients may substitute local primary care providers for sub specialists, or they may decide to postpone or forego care. Many social determinants act as barriers for rural communities to access health services.

      Challenges faced by communities in rural areas are:

      • Higher poverty rates, which can make it difficult for participants to pay for services or programs
      • Cultural and social norms surrounding health behaviors
      • Low health literacy levels and incomplete perceptions of health
      • Linguistic and educational disparities
      • Limited affordable, reliable, or public transportation options
      • Unpredictable work hours or unemployment
      •     Poor primary healthcare and infrastructure in rural areas
      •     Lack of access to tuberculosis testing and treatment centers in remote unreached areas
      •     Unregulated indigenous system of medicine
      •     Poor airborne infection control
      •     Poor nutrition and Malnourishment 

       

      Community mobilization strategies in rural areas include:

      Image
      Community mobilization strategies for rural areas

      Various committees which play a role in community mobilization in rural areas:

      Image
      Community strategies for rural areas

      •      Village Health Sanitation and Nutrition Committees (VHSNCs) - In each Gram Panchayat, Village Health Sanitation and Nutrition Committees (VHSNCs) have been formed at the village level under National Health Mission (NHM). These committees are entrusted with community-level planning and implementation of health and sanitation, and have representation from the local government, local health centre, and the local community. 

       

      •      Panchayat Raj Institution (PRI) - Members of PRI refers to local self-government at the village level. The village pradhan (head) and members of the Panchayat are elected members of the Gram Panchayat. They are the key people who can, after sensitization, mobilize the community for TB care and control and make allocations for TB patients’ nutrition and travel requirements.

       

      •      Yuva mandal/Mahila mandals (Youth/women’s clubs) - Community-level federations of young boys/girls/women, sometimes even comprising several women SHGs. 

       

      •     Self-help groups (SHG) - An SHG is a group of individuals with a homogenous social and economic background, who voluntarily come together to regularly save small amounts of money and contribute to a local fund to meet the members’ emergency needs on a mutual help basis. These groups collectively manage their payments and ensure proper use of credits. Many NGOs currently engaged in the project are involved in formation/registration of these SHGs. It would be advisable to involve these NGOs for ease of implementation. 

       

      •     Community-based organizations (CBO) - A CBO is a small group of people from a community, who come together for a particular purpose. It may be a local association of people mobilized around water conservation, mother and childcare, sustainable agriculture, education, or adolescent health; a group of social service persons; or any other such active group in a village. 

       

      Resource: 

       

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

       

       

      Assessment: 

       

        Question    

      Answer  

      1    

      Answer 2    

      Answer 3    

      Answer 4    

      Correct answer    

      Correct explanation     

      Community mobilization strategies in rural areas includes empowering key decision-makers, people affected by TB, and marginalized and vulnerable populations.

       

       True

       False

        

         

       1

       

      This leads to raising awareness of services available and general health literacy surrounding TB. 

       

      More people accessing public health services will lead to better utilization of services.

       

       

       

    • Community mobilization strategies-Urban areas

      Content

       

      India has historically been called a rural economy but has witnessed fast-paced urbanisation in the last few decades. Currently, one-third of our population is urban. It is projected that by 2030, 46% of our population will be living in cities. Urban areas are characterised by high economic activity, diversity of livelihood opportunities and infrastructural development. Migrants are drawn to urban areas for employment opportunities and to establish a better life for themselves and their families. 

       

      Challenges faced by communities in urban areas: Most individuals and families living in urban areas face multiple and overlapping vulnerabilities. The vulnerabilities faced by urban people come from:  

      •  

      • 1. Residential vulnerability: Slum or slum-like habitations face the insecurity of tenure and are unserved or under-served with basic public services like sanitation, clean drinking water and drainage.  

      • 2. Occupational vulnerability: Urban residents working in the informal sector, daily wage labourers, factory workers working without adequate safety equipment, sanitation workers without adequate protective equipment and bonded labour are occupationally vulnerable.  

      • 3. Social vulnerability: Hinders access to resources such as health services, education and access to government schemes/ programmes because of societal discrimination. Widows, transgenders, the elderly, the disabled and those belonging to scheduled castes and tribes face discrimination because of their disadvantaged social status.  

       

      Social and systemic barriers to accessing public healthcare services in urban areas:  

      •  

      • 1. Limited availability of government primary healthcare services: Primary healthcare facilities in urban areas are limited in number. Urban residents have access to ‘larger’ or secondary/ tertiary hospitals (even for minor ailments) and private sector providers, paying heavily out of their pockets.  

      • 2. Overcrowding in public hospitals: Patients are forced to procure products and diagnostic services from other private providers due to lengthy waiting times.  

      • 3. Inconvenient timings: As most public health services open in the morning hours, consulting a doctor may mean the loss of a day’s wage for the poor. The alternative is to go to private doctors during evening hours. 

       

      Community mobilisation strategies for urban areas: Key strategies for community mobilisation in urban areas to facilitate improved case-finding, testing and treatment are given below.

      •  

      • 1. Peer outreach at TB testing and treatment sites: Peer educators will be linked with TB service providers. These can be peers from a targeted intervention or HIV care and support programmes. Community or peer-led measures will penetrate better and facilitate Intensified Case Finding (ICF).   

      • 2. Mobile unit with the display of Information, Education and Communication (IEC) materials along with a facility for sputum collection and transportation.

      • 3. Safe virtual or physical spaces (for example telephone hotlines, or drop-in centres) to seek information and referrals for care and support for TB treatment. Weekly/ fortnightly awareness sessions, testing days and follow-up testing days for TB can be organised in coordination with District TB Officers (DTOs). 

      • 4. Involvement of Community-based Organisations (CBOs)/ civil societies

       

      Various departments/programs which play a role in community mobilisation in urban areas: 

       

       

      •  

       

       

       

      Resources  

       

      • Tuberculosis Control Measures in Urban India, ADB South Asia Working Paper Series, Asian Development Bank, 2020. 

      • National Urban Health Mission: Orientation Module for Planners, Implementers and Partners, NHM, MoHFW, GoI. 

       

       

      Assessment 

        

       
       
       
       
       
       
       

        

       Question     

       
       
       
       

      Answer   

      1     

       
       
       
       

      Answer 2     

       
       
       
       

      Answer 3     

       
       
       
       

      Answer 4     

       
       
       
       

      Correct answer     

       
       
       
       

      Correct explanation     

       
       
       
       

      Collaboration of National TB Elimination Programme (NTEP) and National Urban Health Mission (NUHM) is to develop strategies to address urban TB. 

       
       

       False  

       
       

       True  

       
       

          

       
       

          

       
       

       2  

       
       

      National Urban Health Mission integrates vertical health programs in its services. It makes special efforts to make its services accessible by the urban marginalized population through its location, service delivery, outreach and making its service providers sensitive to the needs of its target population. 

       

       

       

      1.  

    • IEC material for general public

      Content

      Information, Education and Communication (IEC) material for the Public has been made available on the Central TB Division official website. In the home page of https://tbcindia.gov.in under the ACSM/IEC option IEC materials like launch video on World TB Day, Posters on TB Arogya Sathi, Ni-kshay Poshan Yojana, Ni-kshay Patrika, Documentaries, Radio Spots, TV Spots/TVC’s, Script for Nukkad Natak’s and Exhibition Panels are available in the public domain. 

      Image
      IEC Material available in Public Domain

      Figure 1: IEC Material available in Public Domain: Source: tbcindia.gov.in 

      Information, Education and Communication (IEC) materials for the general public include:

      1. Mid-Media  
      • Banners
      • Flip charts
      • Wall writings
      • Hoardings
      • Posters
      • Pamphlets
      • Mobile vans and videos on wheels
      • Folk performances
      • Kiosks individuals - Face-to-face communication along with audio-visual communication for better message retention. Useful in dispelling myths and practices.
      Image
      Poster for TB Arogya Sathi

      Figure 2: Poster for TB Arogya Sathi App: Source: tbcindia.gov.in

      Image
      Poster for Nikshay Poshan Yojana

      Figure 3: Poster for Nikshay Poshan Yojana: Source: tbcindia.gov.in 

      1. Mass media
      • Newspapers
      • Television
      • Radio
      • Magazines
      Image
      Snapshots from a TVC’s

      Figure 4: Snapshots from a TVC’s: Source: tbcindia.gov.in 

      1. Social Media
      • Facebook
      • Blogs
      • YouTube
      • Twitter
      Image
      Ni-kshay e-patrika

      Figure 5: Ni-kshay e-patrika: Source: tbcindia.gov.in 

      1. Interpersonal Communication (IPC)
      • Counselling
      • Home-visits

       

      1. Community Dialogue
      • Public meetings and gatherings
      Image
      Script for Nukkad Natak available on Central TB Division website

      Figure 6: Script for Nukkad Natak available on Central TB Division website: Source: tbcindia.gov.in 

       

      Resources 

      Operational Handbook on Advocacy, Communication & Social Mobilisation for RNTCP, Central TB Division, MoHFW, GoI, 2014.  

       

      Assessment

        Question​   

      Answer  

      1​   

      Answer 2​    Answer 3​    Answer 4​    Correct answer​    Correct explanation​   
      Counselling and home visits are not part of the IEC materials/ tools available to the public.   False   True           1 Counselling and home visits are part of the interpersonal communication of the IEC strategy.

       

    • IEC Strategies for Government & Private Medical Practitioners

      Content

      Information, Education and Communication (IEC) is defined as a comprehensive approach that spans across mass media, digital campaigns, strategic partnerships and inter-personal ground level activities. The strategies that could be utilised in IEC for government and private medical practitioners with regard to TB elimination can be categorised under both mass strategies and inter-personal strategies which include: 

      Standardised training of practitioners

      • All practitioners, government and private must  receive up-to-date training as and when the programme launches newer updates to the TB treatment and guidelines.
      • The trainings shall be conducted through the use of standardised materials utilising the Swasth e-Gurukul Platform. 
      • The IEC material developed for the practitioners must not only include TB symptoms but also focus on free diagnostics, free treatment, financial support available under the National TB Elimination Programme (NTEP).
      • Only NTEP approved  IEC materials in the form of print media (pamphlets, posters) or digital media (videos, audios)  shall be provided to the private practitioners in the area by the District TB Officers (DTOs), for display in the health care establishments as well as for patient communication.
      • All practitioners must be trained on the identification of Latent TB infection and importance of initiating TB preventive treatment.

      Capacity building

      • Use of Nikshay Sampark (Toll free number: 1800- 11-6666) for feedback/concerns should be promoted from providers as well as patients. 
      • The training should also be provided to all the practitioners in order to be able to use the Ni-kshay digital application for TB notification and reporting all other related aspects.
      • System should be set up to enable all practitioners to receive the government’s demi official (DO) letters as and when circulated.
      • All government practitioners should be educated on how to build capacities of Mahila Arogya Samiti (MAS) and Accredited Social Health Activists (ASHA) in TB control at the community level.
      • Capacities of District Programme Supervisors , District programme Co-ordinators, Senior Treatment Supervisors should be built under the leadership of the DTO to be able to extend support to the government medical practitioners in day to day TB control activities.
      • Professional medical associations must  be sensitized to conduct regular Continued Medical Education (CMEs) programmes in TB care and elimination for the private sector providers

      Involvement of Patient Provider Support Agencies (PPSAs) and Non-Governmental Organisations  (NGO’s)

      • A list of contact details of local public health staff/officers and PPSA (where present) should be made available to all private providers. 
      • Wherever possible PPSAs must be utilised to help the private sector establishments provide patient centric support by facilitating implementation of a single window for diagnostic and treatment services, notification, patient linkage with social welfare, contact investigation, TB preventive treatment and treatment adherence support. 
      • DTOs should ensure coordination with PPSA for DR-TB services.
      • NGOs functioning in the area may also be involved to support the practitioners in conducting IEC campaigns in the communities.
      • Advocacy and policy support groups may be formed with the practitioners and medical associations to strengthen the TB control activities in the private sector.

       

      Resource:

      Training Modules (5-9) For Programme Managers & Medical Officers, CTD, MoHFW, India,2020.

      National Strategic Plan For Tuberculosis Elimination 2017–2025, MoHFW, India, 2017

      Training Strategy for in- service Capacity Building of a Community Health Officers, Ministry of Health and Family Welfare, India , 2019

      Guidance Document on STEPS (System for TB Elimination in Private Sector) in Kerala.

      Assessment

      Question    

      Answer 1    

      Answer 2    

      Answer 3    

      Answer 4    

      Correct answer    

      Correct explanation    

      Page id    

      Part of Pre-test    

      Part of Post-test    

      Information, Education and Communication (IEC) strategies for government & private medical practitioners includes only interpersonal communication.

      True

      False

         

         1

      Information, Education and Communication (IEC) strategies for government & private medical practitioners includes mass strategies as well as interpersonal communication

          

         Yes

       Yes

       

    • IEC strategies for CHVs

      Content

      Information, Education & Communication (IEC) strategies for community health volunteers (CHVs) are: 

       

      Standardised TB training

      • Training for all CHVs should be conducted through standardised training material approved and published under the Central TB Division (CTD)
      • E – modules available on Swasth e-Gurukul platforms should be used in order to maintain uniformity of the training processes as well as for conducting pre and post training assessments
      • Regular capacity building workshops for CHVs may be conducted along with CTD and partner organizations as per the need of the localities identified.

      Dissemination of simplified IEC tools to all the CHVs

      • NTEP’s IEC material must be simplified, translated to local language and must be provided to all CHVs through the programme.
      • Program / medical jargon (e.g.: District Microscopy centre (DMC)/ rapid molecular tests) must be avoided for ease of understanding.
      • All CHVs must be equipped with necessary permissions and facilities required to display these IEC materials across common access areas, public walls, canteens, factories entry/exit points etc.

      TB related events and community engagement activities

      • Under the supervision of District TB Officers (DTOs), the CHVs must be guided and supported for organising events on the occasion of World TB Day, Village Health and Nutrition Day etc., with a focus to increase understanding of the prevailing TB scenario and also their commitment towards TB elimination. 
      • Community engagement activities must be conducted by the CHVs and should involve role plays, street plays (Nukkad Naatak on TB), video vans, group meetings, outdoor communications especially in the high-risk areas/vulnerable populations. 

      Training on NTEP’s digital initiatives for TB elimination

      • All CHVs must be trained on the functioning of TB Arogya Saathi - a citizen and patient application launched by the Ministry of Health & Family Welfare, India that connects patients to TB health care services.
      • Ni-kshay Sampark the TB helpline (Toll free number: 1800- 11-6666) must be made accessible to all CHVs across various states through which they can seek reliable information.  
      • CHVs must be well-informed about the Nikshay Poshan Yojana and other financial support schemes (travel support, tribal patient support etc.) available for TB patients under NTEP’s direct beneficiary transfer (DBT)

       

      Resources: 

      National Strategic Plan for Tuberculosis Elimination 2017–2025, CTD, 2017 

      N Sharma, A Nath, D Taneja, G Ingle. A Qualitative Evaluation Of The Information, Education And Communication (IEC) Component Of The Tuberculosis Control Programme In Delhi, India. The Internet Journal of Tropical Medicine. 2007 Volume 4 Number 2.
       

      Assessment: 

        Question    

      Answer  

      1    

      Answer 2    

      Answer 3    

      Answer 4    

      Correct answer    

      Correct explanation    

      Training through standardised training material available on CTD website and E – modules available on Swasth e-gurukul is an IEC strategy for Community Health Volunteers. 

       

       

       False 

       True 

         

         

       2 

       

      The community health volunteers can take the course and get certified, which can further aid them in managing TB patients. 

       

      +

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