1. Engagement of Informal Health Care Providers Increases Referrals and Successful Outcome of TB patients in Tribal District of India Using Mobile Technology Authors: Archana Trivedi1 , Sanjeev Kumar2 , Navneet Kumar2 , Abhimanu Kumar2 , Binay Sahu2 1International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi 2Sankalp Jyoti, Ranchi, India
Engagement of Informal Health Care Providers Increases Referrals and Successful Outcome of TB patients in Tribal District of India Using Mobile Technology
Suboptimal engagement of private sector & lack of involvement of informal rural health care providers (RHCPs) in TB care and control remains perceived challenge.
Khunti, a tribal district in Jharkhand was identified with low TB symptomatic referrals & annualised notification rates.
RHCPs were trained to identify presumptive TB patients and refer to nearest microscopy centres through use of mobile technology.
Objective - To engage RHCPs, enhance their capacity to do quality referrals and subsequently contribute to successful outcome within target population.
The target population ~1,30,000 in Khunti is located in hard to reach areas and are vulnerable and marginalized.
Training of RHCPs was done through local NGO partner Sankalp Jyoti in 3 blocks.
Training initiated in Q followed by referrals by trained RHCPs.
These RHCPs refer presumptive TB patients to DMCs, tracks symptomatics through use of mobile application.
Referral increase at DMCs is monitored using before and after analysis and validating in lab records.
These RHCPs are considered engaged if they refer 2-3 symptomatics or do sputum collection & transport or act as DOT Providers.
Comparative analysis of referrals during Q and Q with baseline Q and Q shows a significant increase at implementing sites 106% (n=533/500).
RHCPs whose contribution to the project was almost nil at the beginning of the project has increased significantly in both referrals of TB symptomatics 31% (319/1033) and smear positive TB patients 23% (27 /128) at Khunti
Cumulatively at Khunti over the period June Mar 2017, 2626 TB symptomatics referred of which 2057 (79%) have been tested and 288 have been diagnosed with TB.
Of the 132 patients provided DOTS by RHCPs at Khunti during period June Mar 2017, 113 had treatment outcomes reported. Of these 113 patients, 93 % (105/113) had a successful treatment (cured/completed). 19 patients are still on treatment.
Referral increase in implementing DMCs in Q to Q (Khunti)
There is remarkable contribution in diagnosing TB patients , substantial increase in referrals and successful outcome of TB patients in implementing DMCs through trained RHCPs by using innovative digital tool, mobile application.
Engagement of RHCPs is assisting in early diagnosis/ treatment of TB patients who visit RHCPs in remote geographical areas for primary healthcare.
Introduction
Description
Lessons Learned
Implementing Site
% increase in referral
(base line Q12013 & Q4 2012– V/S reporting quarter Q & Q4 2016)
Khunti
106 % ( 533/500)
Time Period
Project Contribution
(Referral)
Smear Positive TB Patients
 Oct 2016-Mar 2017
 31% (319/1033)
 22% 27 /128)
Conclusions