Srimoyee Biswas

Keeping in line with the mission of ‘TB Mukt Bharat’ and ending the TB epidemic by 2025, the Ministry of Health and Family Welfare (MoFWM) and Ministry of Tribal Affairs of Government of India have come together to launch the ‘Tribal TB initiative’.

The initiative specifically aims at addressing the malnutrition problem among the tribal community, which was worst affected by the COVID pandemic and faced the highest rates of TB within the Indian population. The collaboration will pan over fours years aiming to diminish the problem and also lead the country a step further in attaining the Sustainable Development Goals of 2030 (Goal 3: Good Health and Well-Being).

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Background

In 2019, according to the Nikshay Portal’s data to the Government of India, the country has witnessed a decrease of 25% in registered cases of TB but it still renders India as one of the top few countries with the highest TB affected population. In order, to tackle this problem, the initiative aims at a multi-stakeholder and multi-sectoral approach to analyze the various dimensions and provide adequate solutions to the problem.

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Source: Central TB Division Annual Report 2021

Performance

The initiative revolves around vulnerability mapping among the population and the active cases among them along with the vulnerable population in line. The technical assistance from this program from the United States Agency for International Development (USAID). After the rolling out of the scheme for the year 2021-22, the intervention has been rolled out for all the states under the Fifth and the Sixth schedule. The main tasks involved conducting sensitization workshops, Active TB case finding drives, introducing the provision of Isoniazid Preventive Therapy (IPT), and finding long-term measures in reducing vulnerability among tribal groups.

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Source: Tribal TB Initiative document stating the number of tribal districts of identified states

Impact

So far even though the assessment will probably be evaluated on a yearly basis, so far the impact areas have prospectively covered wide areas:

  • National Program Management Unit (NPMU)– Setting up NPMU will evaluate the impact and the evaluation assessments of the initiative.
  • Involving Jan Arogya Samiti and Jan Andolan initiatives to organize and set up volunteering camps and training of faith healers and other community influencers, to have harnessed the charismatic factor to reach out to a larger population.
  • Have roll out’s for Isoniazid Preventive Therapy (IPT) within the desirable districts and closely monitor the health improvements occurring within.
  • Keeping a harmonious approach in implementing the goals of the Central Tuberculosis Division (CTD) of the Government of India.

Emerging Issues

Despite being an initiative that echoes the concerns of a truly underdeveloped section of the population and concerning their health there are still issues that are yet to be addressed and evaluated:

  • Private hospital spaces over government spaces– TB as a health problem is often sought relief for in private hospitals thus bringing more private stakeholders into the issue. This naturally makes the costs go higher and if government hospitals do not have adequate resources and relief at their disposal especially for the more remote and far-flung areas then the initiative will not be able to attain its objective
  • Determining age-sex characteristics of the patients– Not simply mapping tools but more elaborate measures to pinpoint age-sex characteristics will give more valuable insights into the more vulnerable community as a whole.
  • Difficult to Treat TB cases– Some variants of TB require more focus from experts and are especially difficult to navigate with the current equipment and resources in place and there needs to be a more expert-led mechanism in place which will look into it.

Way Foward

While this is an initiative that has truly been able to address an issue that looks into addressing the issues of the tribal communities in terms of health and well-being. However, this initiative will only much later, sometime around the next year, morph into determinable results. While there are indeed certain drawbacks to the convergent approach it might lead to monopolization to an extent and fully reach out to the districts.

A more quarterly approach in terms of statistics and developments will enhance the understanding of areas where there are shortcomings and address the same. The health of the tribal population should be a priority of most government branches because introducing schemes will definitely be useful but only with successful impact assessment and evaluation will lead to more comprehensive solutions being made to address the issue at hand.

References

Dr Harsh Vardhan launches Tribal TB Initiative in pursuit of ‘TB Mukt Bharat’. (n.d.). Retrieved from https://pib.gov.in/PressReleasePage.aspx?PRID=1707909

Ministry of Health & Family Welfare-Government of India. (n.d.). Retrieved from https://tbcindia.gov.in/showfile.php?lid=3587

Ministry of Health & Family Welfare-Government of India. (n.d.). Retrieved from https://tbcindia.gov.in/showfile.php?lid=3606

Sharma, S. (2021, September 01). USAID chips in to power India’s goal to eradicate Tuberculosis by 2025. Retrieved from https://www.indiatvnews.com/news/india/usaid-chips-power-india-goal-eradicate-tuberculosis-2025-latest-national-news-updates-730652

About the Contributor

IMG 1921

Srimoyee Biswas is a researcher at IMPRI. She is currently pursuing her Master’s degree in Social Exclusion and Inclusive Policy from Jamia Millia Islamia, New Delhi

Picture Courtesy: healthmarketinnovations.org