Supporting DR-TB Patients Through Counsellor

Background

Treatment of Drug Resistance TB is complex public health problem and an obstacle to effective Tuberculosis TB control The Social factors associated with Loss to follow up in DR-TB are lack of social support, lack of counselling, no awareness regarding Treatment.

The project was started in Gujarat in September 2016 with the aim of providing psychosocial counselling to DR-TB patient and caregivers through Saksham DR-TB counsellors, based on the social structural approach to disease prevention and control.

Major role of counsellor is to provide pretreatment counselling to Drug Resistant Tuberculosis (DRTB) patients and aid in early treatment initiation, conduct home visits for family counselling and successive visits to patient’s home for follow up counselling.

Programme Achievements

Since inception, Saksham DR-TB counsellors in Gujarat have registered 97% DR-TB patients who were initiated on treatment by RNTCP for counselling services.

One of the major aims of DR-TB counselling is adherence to treatment and completion of treatment.

The counsellor reinforces the adherence messages and address barriers to adherence during every follow up counselling. Priority based follow up counselling visits are provided out of which more than 75% follow up visits are done at home, rest in health posts and other areas like religious places, market etc.

Saksham counsellors are alert about any instances of treatment interruptions and out of the total treatment interruption instances, 74% patients were counselled and were retrieved back on regular treatment. Adverse events due to DR-TB treatment being one of the most important reasons for treatment interruption, Saksham counsellors are also focusing on ADR referrals so as to ensure prompt management of ADR’s and 92% of the referred cases were medically managed.

Saksham counsellors have linked 1461 DR-TB patients to various social protection schemes including Aadhar card, Ration card, Bank account, Ayushman Bharat, etc. Also, counsellors have linked 2457 DRTB patients to nutrition support linkages like provision of milk, curd, eggs, protein powder, rice, dal, etc., through various private donors and NGO’s in order to help them adhere to the treatment. Further, 3474 DR TB patient contacts referred for testing, out of which 92 were found to be M-TB positive.

Source : We Care Coffee Table Book - Good, Replicable and Innovative Practices 2019