- Use of sputum testing as the Primary method of diagnosis among self reporting patients.
- Standardise treatment regimens.
- Augmentaion of the peripheral level supervision through the creation of a sub–district supervisory unit. A sub–district tuberculosis unit (TU) will be established in an existing CHC/Block PHC/Taluka Hospital which will function as managerial unit of the programme for 5 Lakh population (for 2.5 Lakh population in tribal area) and will consist of a designated medical officer Tuberculosis Control (MO–TC) who does tuberculosis work, a senior treatment supervisor (STS) and a senior Tuberculosis laboratory supervisor (STLS). For diagnosis one Microscopic centre (MC) will be located at PHC/CHC/Taluka Hospital for 1 Lakh population(50 thousand in tribal area).
DOTS – Centres will be located at places convenient to the patients and providers and should generally be available atleast at the subcentre level so that patient need not travel more than 5 km.
DOTS–will be provided by
MPWs, TBAs, AWWs, CHVs, who will be made accountable.
- Ensuring a regular uninterrupted supply of drugs upto the most peripheral level.
- Augmentation of organizational support at central and state levels for meaningful coordination.
- Emphasise training, IEC, Operational Research and NGO Involvement in the programe.
- Increase budgetary outlay.
DOTS – (Directly Observed Treatment Short Course Chemotherapy).
1) Community Participation as a DOTS Provider in RNTCP
Mumbai Municipal Corporation
Mr. Prem a 35 year old shopkeeper runs his Pan House at Nocil Naka Ghansoli which is a slum pocket under Urban Health Post Ghansoli. He started assisting the programme from beginning i.e.2001 and is one of our best DOTS provider till date. Prem has good knowledge in observing treatment. As a local person patients have respect for him and generally do not miss doses because his shop remains open from morning 6AM to 10 PM. He actively takes part in defaulter retrieval mechanism. Out of 58 patients of all categories at his center 50 patients have successfully completed treatment till date. He was selected our best DOTS provider for the year 2003.
2) Community Participation as a DOTS Promoter in RNTCP
Mr. Renukadas Manthekar, aged 50 years, residing at Tryambakeshwar, Dist., Nashik is working as a lifeguard at Kushavart lake. He was diagnosed as suffering from tuberculosis 3 years back and was registered and given DOTS treatment at Rural Hospital Tryambakeshwar. Now he is completely cured and is acting as DOTS promoter.
Every year, lakhs of people visit the Kushavart lake. Renukadas guides them over a loudspeaker and gives them instructions regarding swimming and bathing in the waters. Along with these instructions, he also gives them information regarding TB and DOTS. He actively takes part in case detection by sending tuberculosis suspect cases to the Rural Hospital for confirming diagnosis and putting on DOTS. Due to his efforts, 12 patients suffering from tuberculosis have successfully completed treatment till date.
Role of NGOs
Involvement of NGOs in RNTCP
NGO’s are involved in RNTCP in 5 schemes as follows
|Health Education and community outreach
|Provision of DOT
|In Hospital care for Tuberculosis
|Microscopic and Treatment Centre
|Tuberculosis unit Model
Involvement of PPs in RNTCP
Private Practitioners are involved in RNTCP in following schemes
|Provision of DOTS
|Designated Paid Microscopic Centre- Microscopy Only.
|Designated Paid Microscopic Centre- Microscopy & Treatment.
|Designated Microscopy Centre-Microscopy