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The Senior Tuberculosis Laboratory Supervisor (STLS) interacts with the TB patient care ecosystem from the time a presumptive TB case is identified, examined, diagnosed, notified, and put on anti-tuberculosis treatment till the completion of treatment.
Sputum collection centres collect, package and then transport samples to nearby TB diagnostic centres/ Designated Microscopy Centre (DMC).
Sputum is collected and packaged utilizing the triple-layer packing as per National TB Elimination Programme (NTEP) Guidelines.
Overview of the organisational structure of the health system in relation to the National TB Elimination Programme (NTEP) is shown in the figure below.
Resources
Root Cause Analysis of Low Performance in Percentage of People Living with HIV (PLHIV) given Isoniazid (INH) Preventive Treatment (IPT) Against Total Eligible PLHIV
Low performance means the eligible PLHIV are not getting the INH preventive therapy as desired. The data is available with National AIDS Control Organisation (NACO) and analyse it in terms of:
Root Cause Analysis in Percentage of Children given Chemoprophylaxis from the Total Eligible Children Identified
The low performance means the children less than 5 years of age who are eligible for chemoprophylaxis are not receiving it as desired.
The data is available in Ni-kshay; analyse it in terms of :
Root Cause Analysis for Low Performance in the Percentage of Eligible Beneficiaries Paid under Ni-kshay Poshan Yojana
Low performance means the notified TB cases have not received even the first payment through Direct Benefit Transfer (DBT) under the Ni-kshay Poshan Yojana (NPY) as desired.
Obtain the data from Ni-kshay and analyse it in terms of:
Root Cause Analysis for Low Performance in Treatment Success Rate
Low performance in treatment success rate means the notified patients are not completing the treatment or cured of TB as desired.
Unsuccessful treatment outcomes are:
(a) Death
(b) Lost to follow-up
(c) Treatment failure
Analysing Ni-kshay data would give information on which among the unsuccessful outcomes requires attention. Analyse the data in terms of:
Root Cause Analysis of Low Performance in Percentage of TB Notified Cases with Universal Drug Susceptibility Testing Done
Low performance means Universal Drug Susceptibility Testing (UDST) is not done for the notified TB patients as desired.
At the TB Unit (TU) level, obtain the list of patients not offered UDST from Ni-kshay. Write against each patient why UDST is not offered. Analyse the reasons.
Root Cause Analysis (RCA) for Low Performance in Percentage of TB Notified Patients with Known HIV Status
Low performance in the indicator means that the notified TB cases are not getting HIV tests done as desired.
Analyse the Ni-kshay data and try to gain more insights into the problem. Some examples are given below.
The key questions are