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Engagement of non-allopathic/AYUSH health care providers in TB care and control: results of two years of implementation Daisy Lekharu1, Sanjeev Dham1,Sarabjit S Chadha2, Nevin Wilson2 1Population

Services International,2 The Union South East Asia office

BACKGROUND AND CHALLENGES TO IMPLEMENTATION ƒ Non-allopathic health care providers/AYUSH providers (practitioners of alternative systems of medicine - Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homoeopathy) are often the first point of contact for health problems. ƒ Population Services International (PSI), under Project Axshya, has been engaged with this cadre of providers in TB care and control with proven results before its inclusion in the National Strategic Plan (NSP) . ƒ The non-allopathic providers were sensitised on TB diagnosis and treatment in order to build their capacity for early diagnosis for TB and as referral/TB treatment provider.

INTERVENTION ƒ Non-allopath providers in thirty districts in six high burden states (Bihar, Punjab, Haryana, Karnataka, Maharashtra and Rajasthan) have been sensitised through modular trainings in order to: ƒ Develop and enhance their capacities in TB diagnosis and treatment. ƒ Improve referrals and engage them as community DOT providers. ƒ The trainings were provided by technical personnel from PSI with support from the key state and district Revised National Tuberculosis Control Program (RNTCP) staff. ƒ Providers were given referral cards in order to refer TB suspects to the nearest Designated Microscopy Centre (DMC) where the sputum test for diagnosis of TB is offered for free. ƒ Providers were also sensitised on recent policy changes of mandatory TB case notification and ‘ban on serological tests for TB’ in India.

RESULTS AND LESSONS LEARNT

CONCLUSIONS

‰ The number of TB suspects referred by the AYUSH providers increased from year 1 to year 2, showing an increasing trend in number of referrals from AYUSH.

™ This model of partnership with non-allopathic health care providers/AYUSH providers in TB care and control has yielded good dividends and returns on investment.

Programme activities for non-allopathic/AYUSH health care providers

™ However, further engagement through training and capacity building of the providers on TB, including followup for continuous monitoring and supportive supervision, will be vital to the sustainability of the model.

6000 5000 4000 3000 2000 1000 0

5250

Year 1

Year 2

3513 1136

2491

1177 AYUSH trained

TB suspects referred

826 408

1408 Refd suspects reached DMC

357 249

No tested TB No of AYUSH as +ve DOT providers

‰ Of those reached and tested by the DMC, 29% were found to be positive in the first year and 23.5% in the second year. ‰ There has also been an increase in the number of AYUSH becoming DOT providers from year 1 to year 2.

™ It is recommended that facilitation of sputum collection and transport from the provider network is included, which would yield even better results. ™ This network of providers has been recognised as a cadre for engagement in TB care and control under the aegis of the National Strategic Plan (NSP).

Funding was provided by the International Union Against Tuberculosis and Lung Disease through the Global Fund Against AIDS, Tuberculosis and Malaria Contact: Dr Daisy Lekharu, Deputy Director programs Population Services International (PSI) (daisy@psi.org.in) For a copy of this poster go to www.psi.org PSI■■

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Engagement of non-allopathic health care providers in TB care and control