Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya Sripriya Pandurangan, The Union.

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Presentation transcript:

Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya Sripriya Pandurangan, The Union Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Background (Need for the intervention) Low awareness about TB in vulnerable and marginalised population Poor access to health services Delay in diagnosis and further treatment Need to involve other service providers   Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Axshya: Goals and Objectives Improve access to quality TB care and control services through enhanced civil society participation Objectives Improve the reach, visibility and effectiveness of RNTCP through civil society support Engage communities and community-based care providers to improve TB care and control, especially for marginalized and vulnerable populations 374 districts across 23 States The Union – 300 districts World Vision India - 74 districts Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Activities and expected outcomes - Increased case notification - Decrease in default rate - Improved treatment success rates - Universal access to quality TB services Enhanced involvement of all health care providers (especially AYUSH Providers, non-qualified providers) Greater Community involvement (Community groups –VHSC; local self govt. ; self help groups) Increased political and Administrative commitment (District, State and National level) Increased access to TB control services especially by vulnerable and marginalized populations (identification, mapping and targeted interventions) Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Geographical coverage and SRs Districts Activities CHAI 96 Community activities CBCI 29 CMAI 15 EHA 25 MAMTA 62 The Union 13 REACH 14 VHAI 46 PSI 60 Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

A diverse land of over 1.2 billion people….. India….. A diverse land of over 1.2 billion people….. With the World’s highest burden of TB…… Our Vision …. A TB - free India | Our Vehicle…….. Partnerships 16 million people reached in 300 districts across 21 states by 2014 1,200 Non-governmental Organisations 20,000 Community volunteers 9 Sub-recipient partners THE UNION

Axshya SAMVAD Sensitization and Advocacy in Marginalized and Vulnerable areas of District (SAMVAD) District level mapping of vulnerable and marginalized population areas House to house visits by trained community volunteers to increase awareness about TB Identify and link symptomatic cases to TB services Choice of referral/SCT for symptomatic cases. Follow up of those referred by CVs and doing SCT if necessary. Nearly 1000 households visited every month in each district. Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Results of Axshya SAMVAD (Apr 2013 – Dec 2014) 62 % Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Rural Health Care Providers First point of contact for rural and urban poor RHCPs/AYUSH trained and engaged on TB care and control Trained to identify symptomatic cases and refer to nearest DMCs Encouraged to do sputum collection and transportation Motivated them to act as community DOT providers Trained RHCP serving as DOT Provider for 20 TB patients Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

RHCPs – Training and engagement Engaged- Referral of at least 3 TB symptomatic cases per quarter At least 1 sputum sample collected and transported per month DOT Provision- at least 1 patient per quarter Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Results of RHCP engagement No. of RHCPs trained 18879 No. of RHCPs engaged 2442 No. of TB patients referred by one RHCP 15 No. of TB patients diagnosed per RHCP 2 Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Conclusion Active case-finding and engagement of RHCPs through community-based organisations successfully enhances access to diagnosis and treatment of TB for vulnerable and marginalised populations. This has resulted in yield of additional TB cases The interventions can be replicated in other high TB burden countries Sripriya Pandurangan, Novel interventions to enhance access to TB services for vulnerable and marginalised populations: experience from Axshya

Thank you Axshya is a collaboration to support our common objective of reaching out and benefitting thousands of TB patients who continue to suffer because of ignorance and lack of access