Addressing social determinants of treatment adherence among DR-TB patients using an integrated digital platform in Delhi, India

 

About 200 proposals related to TB were received by STOP TB PARTNERSHIP / USAID / UNOPS for the project implementation across the globe for year 2021. Eleven proposals were shortlisted across the globe. BCTA is the proud recipient of one out of the three awarded to India. BCTA is the proud recipient alone in Delhi!! 

 

Project Dream Delhi is being implemented by BCTA across the 5 districts of Delhi for Drug Resistant TB cases, supporting the cause of Government of India’s call for elimination of TB till 2025, five years ahead of the Global goal!!

 

Stop TB Partnership is a global, multi-stakeholder partnership that seeks to achieve a world without tuberculosis through facilitating, catalyzing and coordinating the work of its partners through the Secretariat of Stop TB based in Geneva, Switzerland.

 

Nutrition Support to DR-TB Patients

The BCTA has been providing nutrition support to the DR-TB patients through the Dream Delhi

Project. This nutritional support project is a unique model that not only screens the patient at the district level for nutritional requirement but also offers a complete doorstep delivery of the

monthly nutritional kit to the patient. The screening of the patients is done at the DR-TB center by TB Ambassadors (BCTA employees) with the help of a screening tool. Apart from this, the patients are also provided transportation support so that they can adhere to the treatment and follow up.

BCTA is closely associated with the DTO for coordination and establishing support mechanism for the DR-TB patients. A total of 300 DR-TB patients have been supported by the nutrition kits.

 

Project Objective:

To enhance DR-TB treatment adherence by addressing two social relevant determinants namely food and transport and addressing the mental health needs specifically depression and thereby achieve improved DR-TB treatment success rate among vulnerable populations.

  • Identify the individual needs of newly diagnosed DR-TB patients with respect to food, transportation, counseling and livelihood skill support by using screening tool.
  • Screening 1200 DR-TB patients by 12 months.
  • Provide comprehensive psychological and socio-economic support.  
  • Follow up and assess the impact of the intervention (minimum of 400 eligible patients).

 

Innovation within the project (1)

  • No systematic and comprehensive mechanisms available to identify patients who are at high risk of non-adherence to DR-TB treatment
  • Digital screening tool to identify high risk patients.
  • The tool will be configured on monitor+ platforms
  • Highly configurable
  • Easy to manage
  • Will bring patient, providers, communities and program at one single platform.
  • Enabled with multiple communication channels.
  • Integration of conversational AI

 

Innovation within the projects (2)

  • Data on socio-demographic profile of DR-TB will be collected.
  • Screening tool will identify patients who require psychological support.
  • Counselors will provide continued and long-term counseling and psychological support.
  • Small self-help groups will be formed.
  • Providing meaningful vocational training/small bank loans etc to empower these patients and to encourage each other to adhere to treatment.

 

Activities:

  • 300 patients will be enrolled for transportation and food support.
  • 200 patients will get both the support.
  • 40 patients each will be enrolled for tailoring, imparting computer skills, and beautician training.
  • 100 eligible patients will be enrolled for VDOT.
  • Patients who require counseling support will be linked to a psychologist.
  • Facilitate training, awareness and linkages to existing micro financing scheme to the self-help groups through the support of all possible government subsidies.

 

Evaluation and target populations:

  • Delhi Population 21.75 (2011 census)
  • Total Districts – 11

Proposed intervention sites:

  • LN Chest Clinic
  • Patparganj
  • Shahdara
  • MNCH Chest Clinic
  • Nehru Nagar

 

Proposed evaluation (control) sites:

  • GTB Chest Clinic
  • NDMC
  • RTRM Chest Clinic
  • DDU Chest Clinic
  • Kingsway

Data Quality:

  • TB Ambassadors are using screening tools and technology application at the project site.
  • The application will comply with published data quality mechanisms in the WHO framework and metrics

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