PATHWAY FOR GOVT TO LEVERAGE COMMUNITY RESOURCES FOR PATIENT-CENTREED CARE IN TB
According to the WHO Global TB report 2018, over 7,000 people are diagnosed with TB each day and a life is lost every minute. The Government of India, along with many UN agencies including WHO, has vowed to eliminate TB by 2025. WHP’s Tuberculosis Health Action Learning Initiative (THALI) supports this effort and has become a trend setting project. Expanding from the earlier narrow scope, WHP has added components of advocacy and community action in order to create a well-rounded model for later adoption by the government.
The project started in the city of Kolkata in 2016 to cover all 263 wards. In early 2017, further expansion brought six districts of West Bengal (WB) under its coverage. The project performed exceedingly well with extensive coverage of the private sector and a solid community engagement model that aimed to sensitize the population on TB awareness, and subsequently focused on reducing diagnostic and treatment delays. Thereafter, THALI underwent major structural changes to accommodate and align with the Joint Effort for Elimination of TB (JEET) project. It is currently focusing on a patient support services approach, which includes counselling, adherence and nutritional support. In coordination with the public sector, THALI has been expanded to Jharkhand, Bihar, Uttar Pradesh, Punjab and Gujarat.
THALI is implemented by a consortium led by WHP along with John Snow India (JSI) and Child in Need Institute (CINI) with active engagement of the respective state Governments.
The THALI project is supported by the United States Agency for International Development with a grant of $7.4 million to the consortium for four years.
CURRENT STATUS, LESSONS AND RESULTS:
THALI has undergone a structural shift with the introduction of a patient support services approach. In the earlier stages of implementation in West Bengal, the focus was on synergizing resources in the public, private and corporate sectors. This was an ambitious strategy which in the past commonly suffered from many pitfalls mostly related to inherently difficult coordination. By creating a unified command structure which WHP’s programming model advocates, the project has been able to combine a variety of competencies through specialist organisations. The early results were extremely encouraging with THALI notifying 11,483 cases (in two years) which was 90% of total cases notified by the private sector in six districts of West Bengal (as on January 20th 2020).