Mamta Samajik Sanstha

Brief synopsis of the TB related projects handled by the MSS

Since its establishment, the Mamta Samajik Sanstha(MSS) has effectively launched & completed several Tuberculosis related projects because the twin epidemics of TB & HIV are among the core focus areas for MSS

MSS is an active partner with the RNTCP, The Union (IUATLD) , USAID and The Stop TB partnership

The key TB Control activities of the MSS in the recent past include the following

TB ACSM Project in Haridwar & Almora

The project was implemented by the Mamta Samajik Sanstha & State Dep’t of Health; in association with the USAID and IUATLD from March 2009 to September 2010

The project areas included 6 blocks in 2 districts

• District Hardwar – 4 blocks namely Bhadrabad, Roorkee, Narsan, Bhagwanpur
• District Almora- 2 Blocks namely Chaukhutiya,Dwarahat

The project objectives:

Objective 1: Engage and Empower Communities

Objective 2 : Improve Access by Engaging other sectors

The Project Strategies included the following

1. Formation of Community support group for TB Care Network
2. Strengthen Community TB Care
3. Advocacy, Communication and Social Mobilization -ACSM
4. Support to DOTS activities
5. Other measures as per the inputs from State and District Level Prog. Managers

Key Project Activities comprised of the following

1. Consultation Workshops of District level Personnel (Govt. officers, CMC, DTO, CS,MOIC, CSOs,Local Representatives, PRI),and church based partners
2. State level sensitization of stakeholders like STO, concerned govt. officials, other CBOs
3. Finalization of project locations in consultation with the DTO
4. Block level sensitization of local stakeholders mainly CBOs were held
5. World TB Day events were organized
6. ACSM-Community Support Group for TB care Network -10 groups were formed  in each district
7. Community interaction Meetings with village Health and Sanitation Committee with representation from PRIs, Local SHGs – 4 meetings per month were held in each block
8. Training and follow up trainings of community support groups at Panchayat level and linking with RNTCP
9. De-stigmatization activities – In Aanganwari, Panchayat, School, ICDS etc.
10. Organizing Support Group Meetings – Meetings of Peer Leaders
11. Identification of community volunteers & mobilizing a force of five Volunteers Per Block
12. Patient Provider Meeting at Health Institution

Other activities included

• ICDS sensitization meetings were also undertaken at the District level to sensitize the CDPO and Aanganwari Supervisors/ Workers.  A Total of  152 & 161 personnel were sensitized about TB & DOTS in Haridwar  & Almora  respectively

• Sensitization meetings for the Students and Faculty of the GGIC  (Govt. Girls Inter College), Girls college and Girls Schools (At the district level to facilitate knowledge dissemination in schools. These included quiz, essay competition etc. apart from knowledge dissemination. A Total of  205 & 213 girls sensitized in Haridwar  & Almora  respectively
  

The outcomes of the project were as follows-:

Major Outcomes (Haridwar)

• Community support groups facilitating DOTS access  in place -20
• Community volunteers identified – 20

Major Outcomes (Almora)

• Community support groups facilitating DOTS access  in place -20
• Community volunteers identified – 10

Project for TB awareness & DOTS expansion at Nagthaat – Kalsi, Dehradun

The MSS conducted this project in one of the hilly and remote areas of district Dehradun i.e. Nagthaat region in Kalsi block. The terrain is very difficult, the population comprises of scheduled tribes and the nearest health facility is not accessible to most of the population

The following activities were undertaken

• A base line survey was conducted with 100 families in 7 project villages in January, 2009.
• We appointed one Lab technician and 4 field coordinators for implementing project activities.
• Conducted 3 day training of trainers for project staff and identified  30 DOTS Providers
• Conducted stakeholders orientation involving local grassroots level functionaries like ASHA and Aganwadi workers, civil societies, PRIs, women groups and youth power to promote RNTCP and DOTS and work as DOTS Providers and sputum collection centres
• Conducted Advocacy, Communication and Social Mobilization (ACSM) drive with the stakeholders in 20 project villages and adjoining hamlets to create awareness about TB, and DOTS

Outcomes of the Project were as follows -:

• The MSS identified and trained 30 DOTS Providers in with the help of Dist. TB unit to collect sputum from 20 project villages and provide support in case detection, early reporting, case retrieval, case holding, regular DOTS treatment, follow up and referral etc
• We tested the sputum samples of 990 suspected patients in 30 villages through our lab technician and detected 19 new patients, which were referred to the PHC for treatment.
• We conducted refresher trainings for the project staff and DOTS Providers once in three months.
• Also conducted Block level TB Alliance Meet once every 3 months at Kalsi Block with all the stakeholders and encouraged them to actively participate to promote RNTCP and DOTS in their respective areas.
• The MSS also undertook house to house visit to 575 families in 20 villages to convey the message about RNTCP and DOTS and also to promote collection of sputum of suspected patients.
• Nukkad Nataks, street play and college campus activities were conducted to create mass awareness in the project villages
• A total of about 10500 People attended the community awareness meetings
• 3575 people were covered by house visits to spread awareness about DOTS and TB
• The MSS also undertook wall writings in 80 villages for awareness about TB

Results of the Nagthath Kalsi project (Summary)

GFATM Round 9 TB project to foster civil society involvement in Uttar Pradesh and Uttarakhand

The Project Objectives are

• Establish and enhance capacity for quality assured rapid diagnosis of DR TB in 43 Culture and DST laboratories in India by 2015
• Scale-up care and management of DR-TB in 35 states/Union Territories of India resulting in the initiation of treatment of 55,350 additional cases of Drug Resistant TB (DR-TB) by 2015
• Improve the reach, visibility and effectiveness of RNTCP through civil society support in 374 districts across 23 states by 2015
• Engage communities and community-based care providers in 374 districts across 23 states by 2015 to improve TB care and control, especially for marginalized and vulnerable populations including TB- HIV patients

Mamta Samajik Sanstha is in this partnership as a sub recipient under the Union and is carrying out the following interventions in UP and Uttarakhand districts.(All the activities are in close association with the state and district level RNTCP personnel)

• Organizing trainings for community volunteers on behaviour change communication.
• Organizing trainings for the  networks of local NGOs in consultation with RNTCP, to serve as a mechanism to reach CBOs and communities.
• Mobilize, sensitize and advocate with existing Village Development Committees (Gaon Kalyan Samitis), schools, women groups (Mahila Mandals), SHGs (self-help groups), and other CBOs
• Conduct community wide awareness programs through rallies, village announcements, articles in local dailies and road shows on World TB Day & International Women’s day in consultation with district program officers
• Sensitize, disseminate & promote adoption of the Patients’ Charter for TB Care among all stakeholders & displaying them at prominent places through the above meetings
• Support and expand RNTCP diagnostic and microscopy services, and help link patients with DOT services
• Expand the network of quality-assured routine laboratory services in the districts by encouraging and sensitising NGOs and private hospitals to register under RNTCP’s scheme for sputum collection/ transport and microscopy centres
• Train health staff in the districts in interpersonal counseling and other ‘soft’ skills,
• Build capacity of CBOs in each district to strengthen systems and improve partnerships for overall organizational effectiveness.
• Facilitate quarterly meetings of the above CBOs with District TB Officers through TB forums and help them participate in all community-level mobilization activities.
• Improve community involvement in caring for TB patients, including DR-TB patients, reducing initial default and supporting treatment adherence, especially those on re-treatment
• Support collection and transportation of sputum to diagnostic services and link those who test positive to DOT providers, in hard-to-reach areas.
• Facilitate support to those on treatment and link them with social support schemes and promote dialogue among patients, public health staff and community organizations through the community-level meetings. These activities aim to keep patients from interrupting treatment and to reduce initial defaulters, including those on re-treatment.
• Develop and orient a forum for TB care in each district with the participation of women, cured patients, tribal populations and aged persons. The forums will facilitate quarterly meetings of community organizations with district health services for better service delivery and ‘community monitoring’ of RNTCP
• The rural healthcare providers in India, have strong local/community links so the CBO/NGO networks are being used to increase their participation and align them with RNTCP.
• Facilitate quarterly review meetings of enrolled providers with district programme staff and ensure compliance with International Standards of TB Care (ISTC)
• Facilitate establishment of cross linkages between ICTCs and DMCs, through quarterly joint meetings in each district to review challenges and gaps