ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a): The details of the number of Tuberculosis Centres operational across the country, State / UT-wise including West Bengal are enclosed at Annexure.
(b): After the Prime Minister’s letter to Chief Minister on TB, several State/UTs have intensified monitoring and review of the progress on tuberculosis elimination. The review aims at tracking progress on key priority and new initiatives undertaken by Revised National Tuberculosis Control Programme (RNTCP) like daily regimen, universal drug susceptibility testing, active TB case finding in vulnerable groups and cross reference between HIV and TB control services.
State/UTs are conducting review of the programme under the Chairmanship of Health Minister or Secretary Health at the State level. Similarly, the programme is reviewed by the District Collector / Magistrate at the district level. The State level reviews are conducted quarterly, and the District level reviews are conducted monthly.
The Central Government is also regularly monitoring the State Governments on implementation of the Revised National Tuberculosis Control Programme (RNTCP).
(c): Nikshay Poshan Yojana (NPY) for providing financial incentive of Rs 500/- per month for nutritional support is being delivered since 1st April, 2018 through a DBT mechanism by linking of NIKSHAY portal with Public Financial Management System (PFMS). The scheme has been onboard in DBT portal.
Guidelines have been developed and issued to all States/UTs. Through NIKSHAY a beneficiary wise list is generated and the same is duly submitted to PFMS after validation by the competent authorities at the district level. For demand generation, the districts are popularising the scheme using local measures. The private sector is being sensitized through district level branches of professional bodies like the Indian Medical Association (IMA) and Indian Association of Paediatrics (IAP)
o Directives have been issued to all State/UTs to expedite implementation of the scheme and regular review and monitoring of the State/UTs is being undertaken by the Central Government.
(d): Reaching to TB patients in private sector has been one of the key priorities in the National Strategic Plan (2017-25) for elimination of TB in India. To this effect, JEET project aims to set-up structures to strengthen existing systems to extend quality of TB care to TB patients seeking care in private sector. To have maximum impact within the resources available, the project activities are planned for a limited duration (Jan 2018 to March 2021) and in selected 33 cities & 358 districts of the country where at the time of selection, higher number of private sector notifications were reported to the RNTCP through NIKSHAY.
In the remaining districts, wherein there is a significant presence of private sector, including Bolangir district, the above project provides for technical support through Public Private Mix Coordinators specifically to support private sector engagement.
(e): Adequate drugs have been procured by the programme to account for all patients including private sector patients in the country. For any patient in public or private sector including those under JEET project once diagnosed/notified are eligible to avail programme drugs. The supply chain management for programme is being extended through a software i.e. Nikshay Aushadhi to supply drugs to the private doctors/chemists for storage and distribution.
(f): Standardized care in private sector is one key element of private sector engagement strategy. First step is to obtain notifications from private sector. Private doctors in all districts are continually being approached for notifying TB cases. Once adequate data on private doctors treating TB patients is obtained then these are the ones being targeted with IEC, CMEs, workshops and notifications to adhere to the Standards of TB Care in India (STCI). Following STCI improves diagnostic and treatment practices of private sector including treatment adherence support, follow up, Contact Tracing, Chemoprophylaxis & social support systems to their patients.
Complete follow up helps to track treatment outcomes of different patients treated by practitioners.
Also a Memorandum of Understanding (MOU) has been signed with Indian Medical Association (IMA) for nationwide sensitization of the private practitioners on standard TB care and RNTCP. The national level workshop for State level coordinators of IMA was recently held in Mumbai. About 1000 Continuing Medical Education programmes are planned, which would sensitize 50000 private providers and 10000 additional providers are estimated to be registered in Nikshay, following this activity.
Also, under programme strict enforcement of provisions of Schedule H1 in coordination with State/District Drug Controllers is being initiated. The details of patient and doctor prescribing Anti TB drugs are being recorded and registered in Nikshay portal. This surveillance data is used as intelligence to understand treatment practices and accordingly identify those needing further training/guidance. Public Health Actions as appropriate are being provided to all patients seeking care in private sector.
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