Hashiye Par Khadey Gaon Tak
To the marginalized villages of Bihar
Elaboration on TB Elimination Programme by Shyam, Yuvraj Singh & team
Written by Pushplata Bhardwaj
Galvanizing a whatsapp message into a blog started with coordinating people related to the text content. The message was forwarded to me by Dr. Ravikant Singh (Founder, Doctors For You). It was a simple - heartfelt message in Hindi mentioning about a thanks and conferred respect of tokens from a TB patient Mr. Vijaynath Choudhary to Doctors for You field Officer Mr. Shyam.
Counseling to fill life and expedite recovery in TB patients
Shyam is a Field Officer with Doctors For You in Bihar for TB elimination program. From a city area of Samastipur district, he travels to counsel TB patients to the last village in the Patori block of the district on his bike. He joined DFY during the second wave of Covid 19. He has counseled 600 TB Patients since then. He informed me with enthusiasm
“In our observation, cases of TB are found more in the rural areas. People are usually scared to visit doctors or discuss or report, when they get diagnosed with TB. It is a communicable disease. They face discrimination or restriction from the villagers.”
Treatment of the Patient Vijaynath Choudhary, took long, almost 12 months. When I came into contact with Vijay ji, I realized he was fearful. He either missed his doses or sometimes reduced the doses or kept on changing doctors, as per his convenience. In consultation with doctors, he was advised that his condition might get worse with the development of MDR, if he keeps on going with missing doses.
Vijay ji tried to follow the advice. Whenever he felt discomforted or breaking down, he called me for guidance. With time, I became his friend. Tracked his recovery with follow ups, home visits, regularly. I feel very happy to see him recover. On recovering, he called me at his home to give thanks, gave a few things in honor and sweets for the Doctors For You team. He hugged me warmly in gratitude and said - I am surviving because of DFY support, which sent Shyam like angel to help me”
Incidentally, I met Yuvraj (Project Manager PPSA, Bihar State) a day before Christmas in the DFY Noida office. On asking about TB program in Bihar, he detailed in length on a paper and elaborated in words -
What was missing is the TB patients data attending Private facilities
Madam, I will tell you a story. The Indian government has set a target to free India from TB by 2025. There are 2 systems/facilities in which a TB patient can get treatment - Public (Govt) and Private. In the Government hospital, services of testing, medication, counseling, follow up are all free of cost to the TB patient under NTEP - NPY (NIKSHAY Poshan Yojana); a direct benefit transfer of Rs. 500 every month until the patient recovers (usually 6 months) and all the data is recorded in the
NIKSHAY Portal. Registration of TB patients on NIKSHAY Portal was mandatory to monitor and track TB patients across India. What was missing is the patient data from the private sector
Later PPIA (Patient Provider Interface Agency) was conceptualized to engage with the private sector to notify and create IDs for patients. It lacked efficient tracking of the patient. Therefore, it was relaunched as PPSA (Patient Provider Support Agency).
TB Care To the Marginalized Villages of the Bihar
To improve the TB notifications, free drugs for notified TB patients and extending adherence support to patients diagnosed and treated in the private sector, Doctors For You fully covers 6 districts of Bihar, even the remotest villages. 15 team members work cordially in each district in different capacities and roles (Incharge, Coordinator, Field Officers, Hub Agents, Treatment Coordinators, Lab Technicians, etc).
PPSA Services
- ● Engagement of Private Providers & health facilities such as Private Clinics & Hospitals, Chemist shops, Pathology labs & RMP.
- ● Notification of the TB patients in NIKSHAY portal.
- ● Free Diagnostic services by NTEP (UDST)
- ● Free treatment services & NPY benefits by NTEP (FDC & DBT)
- ● Facilitating access to quality assured treatment and psychosocial support to help patients to complete treatment.
- ● Home visit of the patient for contact tracing and chemoprophylaxis.
- ● Regular follow up and counseling of the patients to ensure the successful outcome.
- ● Special services for TB patients if required.
- ● Call Center Support
Since June, 2020, DFY has notified more than 22,000+ TB patients, targeting 70% UDST, 80% DM, 80% HIV, 80% DBT as said by Yuvraj on coverage “ Shehar se Hashiye Par Khadey Gaon Tak”. TB operations will be extended to 5 more districts in the coming weeks.
