WORKSHOP for Building a Local Roadmap
Wednesday August 29-30, 2018, Hotel Pride Plaza, New Delhi
What is LOCAL ROADMAP FOR TB FREE INDIA?
Local Roadmap for TB Free India is a initiative of RNTCP-CTD, AAPI, CETI, USAID and WHO to develop pilot program to help cities/districts/villages become TB FREE. It has three components.
- Develop a detailed strategic Local Roadmap Plan for a given city/district/village
- Conduct field work for Awareness, Notification and Active Case Finding or another field intervention for 1 million population with local NGO
- Present findings at AAPI Global Health Summit in December 28-29. 2018 in Mumbai
DTOs, STOs, WHO Consultants, Local TB Champion, and NGO leads, MDs of NHM and Administrators from these areas
Indore, Bhopal, Sevak Village in Gujarat, Rajkot, Mumbai-Malad, Ahmedabad, Mysore, Nagpur, Varanasi, Lucknow, RNTCP – CTD Team, AAPI Leadership, CETI Team, USAID Team, WHO Team,CDC,REACH, Guests from Pharma, Other NGOs or Key Person interested in collaborative model , Rotary, Lions, MDs Of NHM,Administrators of various cities, Media.
Goals by December 2018
- Build a team
- Conduct inaugural program
- Brochure on TB Free city/district/village
- ACF or Other activity by NGO of 1 Lac population
- Develop a 50-60 page detailed document on local strategy for TB Free city/district/village which details these ideas
- Build new partners and collaboration for operationalizing the TB Free Roadmap document strategy
- Build a LOW COST – REPLICABLE – SUSTAINABLE AND SCALABLE model
- Total: 100+ people – attended Seated at round tables city-wise
Meet and Greet
Dinner and Reception Informal gathering
Individuals talk about their TB Programs- New Ideas and Success stories
9:00- 9:45 am
“You can take an Indian out of India but you cannot take India out of an Indian” that’s what brings AAPI members to India , with a passion to do something good for the people of India and other partners . AAPI – CETI Collaboration to work on TB Elimination from India.
9:45 – 10:15 AM
Objective of Local Roadmap – Dr. Manoj Jain – Dr.Salil Bhargava – Dr. Kiran Rade and Dr. Nishant Kumar
Dr Manoj Jain discussed the importance of preparing a local roadmap for eliminating tuberculosis. Share documents with various parameters indices for making a road map and shared a copy of the same with each city.
Barriers and Solutions to Eliminate TB – Government’s Perspective Speaker – Health Secretary/Joint Secretary or DDGTB (20 min talk – 10 min conversation and Q&A)
Dr. KS Sachdeva – DDG TB : Share about how the Social history of any disease is very important. And the need to understand how the disease evolved, the causative organism, the disease transmission, spread , outbreaks etc..
Dr Sachdeva shared about the incidence of tuberculosis in different parts of Europe. Before the discovery of TB drug most of the countries of Europe experience a drastic change in tuberculosis and that was because of improved standard of living , good hygiene and nutrition.
In early 90s and experiment in UK was done where they established a small town on the other side of the river where there were big houses , proper ventilation in the houses, lush green gardens, good food and nutrition for the people as compared to the other side of the river where it was crowded and densely populated. The conclusion of the experiment was that number of tuberculosis patient on the crowded and densely populated area was more than that on the other side of the river, where the standard of living and nutrition was good. This lead to the great decline of tuberculosis in Europe.
He also shared information on how TB transmitted more in the crowded areas densely populated areas of the cities and the chances of getting infection.
Role of AAPI-CETI :
Dr Sachdeva focused on the role OF AAPI- CETI is to bridge the gap between DTOs and other Ministries.
The DTOs alone cannot work with other government departments and Ministries and it is very difficult to reach the goal without the support of other Ministries so AAPI -CETI can help DTOs to get support from other Ministries such as District Magistrate , Urban Development Department , Mother and Child Health Care Department etc..
He also focused on engaging other communities to work for eliminating tuberculosis by making them do TB awareness among the locals.
10:15 – 11:00 AM
Mr. Vikas Sheel – Joint Secretary : Mr. Vikas Sheel share his thoughts on Tuberculosis disease and its impact in India.
He also shared information about the problems at technical and managerial level. And suggested to improve it so that the overall outcome for tuberculosis can be better.
He also emphasized on the determinants of tuberculosis , for example the nutritional level and the living conditions , needs to be kept in mind while planning.
Further he was excited to work with the project and committed to run the pilot project for next 4 months with the ten cities to eliminate tuberculosis.
He emphasized on stakeholder management perspective for diagnosis , treatment , sample transport system and also to identify the gaps . Also suggested to add different determinants of training for lab technician for
collecting two samples one for microscopy and other for DST. Other noteables points includes :
- Public Health system and facilities also need to be adequately sensitised
- How to achieve action?
- What will be the implementing action?
- ICE programme implementation?
- Creating patient friendly system for fast diagnosis and treatment with less turnaround time?
He also advise the use of technology to make TB program run smoothly and with full credibility. He also insisted on listing the deliverables with timelines to increase our credibility. During his speech he also focused on Nikshay training and publicity.
Proposals by Joint Secretary:
- He proposed that from CTD 1 officer for each district so that CTD is closely associated to each district and whatever is required by the government of India can be provided seamlessly and fast manner.
- State government to designate one person from state level nodal bodies district for this project. So that teams can get all the help from the government.
- He also focused on connecting to the district collector to know about the project and to organise training and introductory workshop in each of the 10 districts.
- He also proposed on creating district task force by engaging other departments also they meet once in a month and discuss on the progress and the challenges faced by the project in their district.
Summing up the speech he requested, four month down the lane to target
- On understanding the tools and model
- Make some base line to work
- Set up mechanism
Requested the 10 districts to make up their own system and to prioritise the most challenging indicators to work on the first go!!. Customise the tool according to their need and if the district teams can present their plan on the 28th December to meet again.
Concluded by asking, to create this model to replicate elsewhere in the country.
11:15 – 12:00 AM
Panel Discussion: Engaging private sector to eliminate TB
Panelist – Dr. R. Rao- Deputy Dir. TB/Dr. Bhavin WHO Consultant/JEET Representative//Sapna Surendran- (20 min talk – 10 min conversation and Q&A)
Panelist discussed how to involve private and community sector in eliminating tuberculosis. How government is involving doctors under RNTCP programme was discussed by panelist .
Discussed about expectations from private practitioners like,
- They should notify all the patients which are being diagnosed and treated by them.
- All the Laboratories and radiological clinics should report the patients who are being diagnosed private practitioners , clinicians , chest physicians should be notified on Nikshay directly, or can be notified by hard copy to the nearest district TB officer or CMHO.
The government incentive schemes was also discussed, that is to incentivies the private doctors for notifying their patient on Nikshay. They will get on Rs 500 on diagnosis and Rs 500 on completion of treatment.
Those doctors adhering to the procedure will be penalised as per rules laid down by the government .
Also the private doctors are being trained for all these things at National level by Indian Medical Association through their district branches by CMEs the details are also informing them by various means including , WhatsApp groups and other digital methods.
12:00 AM – 12:30 PM
How to Engage the Community, NGOs and Media
General Discussions based on responses to worksheet – Dr. Reuben – The USAID/ Dr Nishant Kumar – Joint director MHFOW / Ms. Smrity Kumar Project REACH Director
12:30 – 1:00 PM
Roadmap for TB Free City – The Details process – Why – Who -How -Group Discussion on what is Roadmap and Vision – Strategy- Operation/Execution Dr. Manoj Jain and Dr. Salil Bhargava
1:00 – 2:00 PM
Lunch – Keynote Address Introduction – Mr. Yash Pal Das – Chairman of Rotary National TB Control Committee, Introduction by Dr. Reuben Swamickan USAID
New Technologies for TB Free City- and Data and Benchmarks – Dr Kiran Rade , Dr. Jyoti Jaju Nikshay/ Dr. Sandeep Mishra- WHO Consultant Dr. Rajesh Deshmukh CDC
Dr. Kiran Rade – NPO TB Epidemiologist at WHO, India
Dr Jyoti Jaju WHO consultant expert Nikshay Project , talked about updates and latest version of Nikshay. She informed that all the aspects from suspecting a patient to have TB diagnosis and treatment will be entered in full detail into Nikshay latest version.
2:00 – 2:30 PM
Dr Rajesh Deshmukh – discussed the importance of data collection and use of this data in the roadmap and how its proper analysis may help in reaching goal of eliminating TB.
Dr Sandeep Mishra – shared information about how the MP government was invited for involvement of pharmacies in state of Madhya Pradesh.
He explained in detailed about the procedure and software by which they have managed to involve the pharmacies /medical stores of MP state.
Due to which now the patients who purchase the TB medicines from these stores are being recorded and reported to the Government of MP and are able to track and monitor which doctor had prescribed the TB medicines which will ultimately push the doctors for notification adherence.
2:30 – 4:00 PM
TEAMS sit together with facilitator on each table and work on their city TB Free plan – Review of their worksheet. Introduction by Dr. Daksha Shah – DTO- Mumbai – Mumbai’s TB Free Journey
Dr Daksha Shah DTO MUMBAI shared about how they had already started working roadmap for TB free Mumbai. She explained in detail about the activities which they have done in Mumbai consisting of mapping of doctors , Laboratories , Radiological clinic and medical colleges and taking their helps by training and involving all of them including private practitioners to make TB free Mumbai.
5 min PPT – Presentation by each group on where they are on TB Free Journey ( 5 min presentation and 5 min Q&A)
Team Gujarat (Ahmedabad and Surat)
5:30 – 6:00 PM
Closing and Next Steps – Dr. Kiran Rade and Dr. Reuben Swamickan