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:
Advocacy refers to activities that seek to influence the influencers and decision-makers, so as to make TB more central as a public health agenda and enlist their (influencers’) support to create an enabling environment in support of the National TB Elimination Programme (NTEP) to eliminate TB. Advocacy fosters political will, increases financial and other resources on a sustainable basis, and holds authorities accountable to ensure that pledges are fulfilled and results achieved.
Patient-provider meetings are important to ensure patient support and improve case holding/ treatment adherence.
Objective: To orient the patients on the course of the treatment, the importance of adherence and the risk for close contact. It also provides a platform to discuss the difficulty in following treatment courses by the patients and the need for further counselling if required.
The district TB forum is a community-engagement modality that aims to empower and engage the TB-affected community. Constituted by TB patients (cured or on treatment), community leaders, government officials, experts and NGOs; it gives a voice to the affected community and advocates with the programme managers for the resolution of challenges faced by TB patients in accessing TB services.
District TB forum is composed of various stakeholders as shown in the table below and its meeting is to be convened at least every 6 months at the district level.
The TB forum for community engagement aims to empower and engage the TB-affected community. The forum acts as a bridge between the community, TB patients, the health system and civil society. In these forums, advocacy activities are undertaken to influence policy changes for accessible, affordable, supportive TB services to the entire population with a special focus on poor and vulnerable groups.
Under the Drugs & Cosmetics Rules 1945, drugs specified under Schedule H are required to be sold by retail on the prescription of a Registered Medical Practitioner (RMP) only. At present, Schedule H contains 510 drugs.
Recently, a new Schedule H1 has been introduced through gazette notification GSR 588 (E) dated 30-08-2013, which contains certain third and fourth-generation antibiotics, certain habit-forming drugs and anti-TB drugs.
These drugs are required to be sold in the country under the following conditions:
As a public health responsibility to prevent transmission of TB infection and development of drug resistance it is essential to engage both the public and private sectors for effective TB prevention and control. A total of seven standards related to Public Health Actions (PHA) (Standard 12 to Standard 18) have been mentioned in the Standards for TB Care in India (STCI)-2014. All patients notified from the private sector also need to be offered all public health actions.
The private-sector health facilities have experts and infrastructure to manage TB cases. Under the direct engagement partnership model, the programme manager directly engages private-sector health facilities which provide TB services to ensure that standards of TB care reach all the patients in that facility.
In a region where there is no dedicated Patient Provider Support Agency (PPSA), the National TB Elimination Programme (NTEP) can directly empanel and engage a private/ corporate/ trust hospital and designate them as “TB Treatment Centres”.
The System for TB Elimination in Private Sector (STEPS) model evolved as a solution to address gaps in the quality of care for patients in the private sector by ensuring standards of TB care in India (STCI). STEPS is envisioned as an equal partnership between the public and private sectors for the benefit of society with TB elimination as the outcome.
The primary objective of STEPS is to address gaps in the quality of care for patients in the private sector by ensuring standards of TB care in both sectors to all citizens in a patient-centric manner.