Tuberculosis is still a leading cause of death in India and reduction of TB mortality is one of the ambitious goals of the National Strategic Plan for TB (2017-25). The Sustainable Development Goal (SDG) and End TB Strategy have also set goals to reduce the TB mortality rate to 90% of the 2015 baseline by 2030. India has aimed to achieve these SDG targets for TB by 2025, i.e. 90% reduction in TB mortality and an 80% reduction in TB incidence. Clinical severity assessment to link the patient with required health services can reduce the mortality rate.

With a view to improve treatment outcomes of TB patients a technical guidance has been developed by National TB Elimination Program (NTEP) for “Differentiated Care of TB Patients”. This approach involves assessment of all notified TB patient in the public sector for basic clinical parameters, right at the time of diagnosis; lays down criteria for risk stratification of TB patients through a scoring system; and institutionalized patient-centred care to mitigate the risk factors for rapid reduction of preventable mortality among TB patients.

World Health Partners (WHP) is implementing “Differentiated Care of TB Patients” project, along with John Snow, Inc. (JSI) through USAID TIFA grant. The project is rolled-out in the high notifying public health facilities of Lucknow, Kanpur, Unnao and Barabanki districts of Uttar Pradesh. The project will develop and implement a comprehensive package of diagnostic and referral services at various health facilities to reduce morbidity and preventable mortality among TB patients.

Project intervention comprises of initial mapping for gap identification; necessary linkages will be established within or outside the public health system to ensure the availability of all required investigations at the time of the screening. The team will screen and segregate TB patients once the mapping exercise is over and training imparted. Patients will be followed up by the centralized control center (CCC) executives periodically to ensure better treatment outcome. Till May 2023, 1,096 patients were screened and 930 patients were followed up for 15 days, 875 patients were followed up for 30 days & 697 patients were followed up for 60 days.

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