STS

Ayushman Bharat (AB) is an attempt to move from a selective approach to health care to deliver comprehensive range of services spanning from preventive, promotive, curative, rehabilitative and palliative care. AB-HWCs are envisaged to deliver expanded range services that go beyond maternal and child health care services to include care for non-communicable diseases, palliative and rehabilitative care, oral, eye and ear nose and throat care, mental health and first level care for emergencies and trauma, including free essential drugs and diagnostic services.

Tuberculosis (TB) unit (TU) is the sub-district level supervisory unit of National TB Elimination Program with the following organogram:

Figure: Organogram of a TB Unit

(PHI: Peripheral Health Institution)

TUs are based mainly on National Health Mission (NHM) health blocks with the aim of aligning with the NHM Block Programme Management Unit (BPMU) for optimum resource utilization and appropriate monitoring.

Guidelines for Laboratory Cleaning

The Laboratory Technician (LT) must safely discard contaminated, biohazard waste generated by tuberculosis (TB) laboratories. This waste must be discarded along with the overall waste of the health facility in which TB services are provided.

There are 2 types of waste generated from DMC laboratory settings:

1. Sputum containers with specimen and wooden sticks
2. Stained slides

Disposal of Sputum Cups with Left-over Specimen, Lids and Wooden Sticks

Longer oral Multi (M)/ Extensive Drug-resistant (XDR) -TB treatment is specified with a definite regime and duration.

Regimen: (18-20) Levofloxacin (Lfx), Bedaquiline (Bdq) (6 months or longer), Linezolid^# (Lzd), Clofazimine (Cfz), Cycloserine (Cs)​​ (^# dose of Lzd will be tapered to 300 mg after the initial 6–8 months of treatment)​

Nikshay portal allows tuberculosis (TB) notification performance of State/District/TB Units/Peripheral Health Institutes on the click of a button.

This helps in periodically monitoring the performance of health units against the targets and helps in monitoring TB notification.

Steps to display and download Nikshay TB Notification Report

Step 1: Open the Nikshay Reports page.

Step 2: Under Notification Reports, click TB Notification.

Nikshay is an integrated Information, Communication and Technology (ICT) platform adopted by the National Tuberculosis (TB) Elimination Programme (NTEP) for TB patient management and care.

The patient management workflow in Nikshay streamlines a series of activities required for TB patients from identification of presumptive TB cases to recording treatment outcomes. Nikshay uses in-built modules in the platform to perform these tasks. There are also different user logins that allow certain functions (see figure below).

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:

Adverse Drug Reaction (ADR), such as giddiness, may occur from the Drug-resistant TB (DR-TB) treatment regimen.

Suspected agent(s) - Amikacin (Am), Ethionamide (Eto), Fluoroquinolone (FQ) and/or Pyrazinamide (Z)

Suggested Management Strategies