Center for Health Market Innovations (CHMI)

Programs

Overview

Implementing organization: 
Government of India
Legal Status: 
Year Launched: 
2002
Stage: 
Existing/expansion stage
Income Level of Target Population: 
20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Government

Scale

Personnel Employed: 
100<
Number of Clients Served: 
More than 100000
Summary: 

The National Tuberculosis Program of India contracts provate providers, mostly non-government organizations (NGOs), to conduct health education and community outreach, train volunteers to provide Directly Observed Therapy (DOT), provide in-hospital care, microscopy, treatment, defaulter retrieval, recording and registration all free of cost for TB patients.

Program goals/rationale: 

Tuberculosis continues to be the largest disease burden in India. NGOs and private practitioners have been the first and only point of contact for over 60% of patients with tuberculosis. Collaboration between the private health provider and National TB Control Programs is necessary to better tackle TB issues.

Key program components: 

The Revised National TB Control Programme (RNTCP) provides commodity assistance in kind and grant-in-aid to support the NGOs involved in the various TB efforts. The process of involvement of NGOs under RNTCP has been decentralized to the district level so as to ensure maximum participation of grass roots level NGOs.

There are five operational schemes under this program.

Scheme 1: Health Education and Community Outreach - NGOs can sensitise the public, train volunteers, disseminate information, and provide counseling to patients and their families. They can sensitize, orient and advocate key groups as well as develop and revise information, education and communication material according to local context. The private provider is expected to cover a population of 1 million for which the grant in aid is Rs. 150,000 per year pro rata for population covered.

Scheme 2: Provision of Directly Observed Therapy (DOT) - NGOs can identify, train and supervise volunteers who will provide DOT treatment. The DOT provider is also responsible for ensuring collection of sputum during treatment and for default retrieval. The provider offering DOT treatment receives Rs 150/- per patient cured at the end of treatment.

Scheme 3: In-Hospital Care for TB patients - The established and experienced NGOs provide hospital care for TB patients who require such care. The hospital performs Acid Fast Bacili (AFB) smear microscopy and follow-up sputum examination of patients on treatment to those who live in areas covered by the RNTCP. Rs 400/- is paid per patient successfully treated with all services including initial home visit and default retrieval; Rs 250/- is paid per patient successfully treated where the initial home visit and default retrieval are the responsibility of another provider.

Scheme 4: Microscopy and Treatment Centre - The NGO serves as a microscopy and treatment centre and is designated as such by RNTCP. The NGO provides AFB microscopy and TB treatment service free of charge. Rs 2,500/- per patient is paid after they are successfully treated; Rs 1000 is paid after completion of IP, and 1500 is paid after completion of OP.

Scheme 5: TB Unit Model – Under the scheme, the NGO provides full services for microscopy, treatment, direct observation, defaulter retrieval, recording and registration as earmarked for TB Unit. Where all the RNTCP services in TB unit are performed, there is one time grant of Rs 200,000 to be used towards set-up expenses, and an annual assistance of 530,000/-. The grant is released to provider only after the completion of treatment; if the treatment is incomplete, or the disease is not cured, the private provider does not receive the grant.

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TB PPP India.pdf20.68 KB

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