Indian Medical Association (IMA), the largest national association of doctors of the modern scientific system of medicine, has announced its efforts and support to eliminate tuberculosis in the state of Bihar as a part of the ‘End TB’ program launched by the central government.
The IMA has been working with the government to develop strategies that effectively address the impediments in the management of the disease, especially the low notification of patients. In addition, IMA will be holding a series of dedicated TB programs for medical professionals across the state.
Bihar has one of the largest number of TB cases in the country with a high number of drug-sensitive TB and multidrug-resistant TB being reported.
“Our aim is to have a TB free India by 2025 and it is essential that we utilise the maximum resources at our disposal to achieve this end. Through these educational sessions, private doctors would be informed and encouraged to notify cases of TB that come to their clinics. They will also find the support required to ensure their patients complete the treatment under the RNTCP,” said Dr Shaligram Vishwakarma, President, Bihar State, IMA.
In 2018, Patna notified 3221 notifications from public health sector and 17939 from private health care sector at the notification rate of 317 per lakh population. In the same year, the state of Bihar notified 64363 patients from public and 41224 patients from private sector respectively with a notification rate of 88 per lakh population.
The Bihar State unit of IMA is working upon to highlight and disseminate the developments pertaining to tuberculosis amongst the private practitioners and masses at large by sensitizing them on the updates in the programmes through workshops and various other initiatives like involving at least one panchayat or block and district coordinators to educate them for the steps taken for TB elimination and providing them technical support for the cause.
In addition, IMA is channelizing the available resources of diagnostics, drugs, NPY-DBT adherence mechanism with rigorous follow-ups for the successful outcome of the patients. The World Health Partners and Clinton Health Access initiative (CHAI) are also working closely to engaging private sector in notifications and adherence in Bihar.
The State of Bihar, have made consistent efforts to leverage upon the above initiatives within the local context and accelerate uptake of these strategies with systematic monitoring and supervision which has resulted in increased case of diagnosis of TB cases.
Under the IMA End TB Project, Continuous Medical Education Programmes (CMEs) is being conducted for IMA members to improve notification of TB patients from private providers, establish linkages for expanding diagnosis, treatment in line with standards of care and thereby enhancing the quality TB care for TB patients.
The TB programs will inform the doctors on guidelines for correctly identifying and diagnosing TB including the Cartridge Based Nucleic Acid Amplification Test (CBNAAT) which can help in diagnosis as well as test for drug resistance and guide in the treatment, the standard treatment procedures including the shift to daily drug regimen from the old thrice-a-week treatment to reduce cases of relapse and drug resistance, notification of patients through the user-friendly NIKSHAY App and the free facilities available for patient treatment under the Revised National Tuberculosis Control Program (RNTCP).
Notification of patients through the NIKSHAY App will enable private doctors to access the various facilities made available by the Government under the Revised National Tuberculosis Control Program (RNTCP) for the benefit of patients seeking care from private sector, including free diagnosis and drugs tests as per the Standard for TB Care in India, as well as the NIKSHAY Poshan Yojana under which every TB patient gets Rs.500/- per month towards nutrition support till completion of treatment.
In Bihar, IMA is regularly monitoring TB notifications and all districts have conducted meetings with Drug control officers and Chemist associations. In addition, IMA is taking innovative steps to promote NIKSHAY app and incentives to improve notification from private sector. The IMA is working to galvanize doctors in the private sector to increase notification and work toward the cause of ending TB by optimal utilization of NIKSHAY.
NIKSHAY, a useful phone app that allows doctors to notify TB patients through a simple interface also helps in TB patient management and care. NIKSHAY has been upgraded to a more user friendly version 2.0 that is compatible with both web based and app based platforms. Private doctors can also use other methods including the Government’s call centre at 1800-11-6666 for notification of TB patients and for support and more information. To encourage doctors to use the NIKSHAY App for notifications, the government has also introduced an incentive scheme for doctors – Rs. 500/- on TB notifications and Rs. 500/- on the report of treatment outcome.