STLS

To achieve universal Tuberculosis (TB) care for all notified TB patients, the National TB Elimination Program (NTEP) has initiated the Patient Provider Support Agency (PPSA) initiative.

PPSA is a model under which a third-party agency/non-governmental organization is selected by a state/ city/district NTEP unit to engage private-sector doctors treating patients of TB and provide end-to-end services, such as diagnosis, notification, patient adherence and support, and treatment linkages. 

The key level for the management of public health services is the district​ level. The District Tuberculosis Centre (DTC) is the nodal point for tuberculosis (TB) control activities in the district​.

Functions of the DTC

The primary role of the DTC is a managerial one. The DTC is the central program management unit of the district responsible for all activities related to National TB Elimination Programme (NTEP) implementation such as:

The anti-TB drugs recommended for treatment of Multi- and Extensively Drug-resistant (M/XDR) TB patients are grouped into three groups –  A, B and C (Figure below).

Figure: Groups A, B and C of Anti-TB Drugs used in Treatment of M/XDR-TB Patients

Figure: Summary of the Sustainable Development Goals

Advocacy, Communication and Social Mobilization (ACSM) activities must place the individual at the centre and bring in the family, community and society to bring about sustained changes in TB perceptions and behaviours. ACSM activities must target these 4 groups accordingly:

There are several communication channels for the effective dissemination of messages.

Below are various channels with their advantages and disadvantages listed.

Once Advocacy, Communication and Social Mobilisation (ACSM) objectives are designed, linking them with activities strengthens the overall programme effectiveness. Several ACSM approaches can be considered for TB. Decisions on which approach or combination of approaches to use should take into account the benefits and risks, the time frame and the expertise and financial resources needed for effective implementation.

There are two parameters to determine:

(1) What ACSM activities to conduct?

(2) Which channels of communication to use?

Advocacy, Communication and Social Mobilization (ACSM) strategies are directed at achieving specific goals in terms of TB elimination.

They are:

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.

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

Types of communication in healthcare are: