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All Ayushman Bharat-Health and Wellness Centres (AB-HWCs) will use Nikshay for recording information of presumptive tuberculosis (TB) patients and drug-resistant TB (DRTB) patients. All AB-HWCs, including AB-HWC sub-health centres, will use Nikshay Aushadhi for drug inventory management.
The following physical records will be utilized for recording and reporting:
At the AB-HWC Sub-health Centre
Under the overall guidance of Community Health Officer, the Accredited Social Health Activist (ASHA) at Ayushman Bharath-Health and Wellness Centre (AB-HWC) perform the following roles:
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:
On the lines of the State Health Mission, every district has a District Health Mission headed by the Chairperson, Zila Parishad. It has the District Collector as the Co-Chair and Chief Medical Officer as the Mission Director.
To support the District Health Mission, every district has an integrated District Health Society (DHS) and all the existing societies as vertical support structures for different national and state health programmes are being merged in the DHS.
The End TB Strategy is based on 3 pillars underpinned by 4 principles (see figure below). The strategy follows a multi-pronged approach incorporating patient-centred care and prevention, bold policies and supportive systems, and intensified research and innovation.
Figure: Pillars and Principles of the End TB Strategy; Source: Proposed Post-2015 Global Tuberculosis Strategy and Targets, WHO, 2015
Universal access to quality TB care is defined as when all TB patients in the community access early, good-quality diagnostic and treatment services in a manner that is affordable and convenient to the patient in time, place and person.
All affected communities must have full access to TB prevention, care and treatment, including:
The quality assurance component of the National TB Elimination Programme (NTEP) drug supply system ensures that each drug used by a patient is safe, efficacious and has appropriate standards of quality.
For maintaining the quality of drugs, a system of pre-dispatch & post-dispatch testing of drugs is established.
In a situation where Drug-resistant TB (DR-TB) patients may have consumed anti-TB drugs for some duration from the private sector, such prior anti-TB treatment is not likely to be uniformly reliable as far as the quality or quantity and duration of drugs consumed is concerned.
Given that uncertainty, the basic principle is that the duration of the DR-TB regimen under the National Tuberculosis Elimination Programme (NTEP) need not be reduced.
Many times, Drug-resistant Tuberculosis (DR-TB) patients diagnosed in the private sector will wish to avail services from the public sector.
The National TB Elimination Programme (NTEP) strongly recommends bacteriological confirmation of any DR-TB patient before initiation of treatment and discourages any empirical treatment.
Drug Susceptibility Testing (DST) results available from private laboratories for such patients will be considered acceptable under the following situations:
The National TB Elimination Program (NTEP) makes an effort to provide Tuberculosis (TB) services to each TB patient, including services to Drug-resistant TB (DR-TB) patients notified/ referred from the private sector.