Diagnosis, Treatment & Awareness – Taking the Fight against TB to over 300 Districts of India

This project is taking tuberculosis treatment and care to people from marginalised communities in 300 districts across India. Here’s how it works.

Rakhi (23) and Sonu (28) got married in 2014 and live in Dhatauli village in Sonepat district of Haryana. They had both been diagnosed with Tuberculosis before marriage and had taken complete treatment. But they preferred not to disclose this information to each other. In May 2015, Sonu’s cough and Rakhi’s fever (common symptoms of TB) reoccurred but they did not go for tests the second time, fearing that the status of the disease would be revealed to their spouse. It was only when Maihar Singh, a community volunteer from Project Axshya visited them in August 2015 and explained to them about TB and why they should get tested immediately that they went for the sputum examination, a simple test for diagnosis of TB. Both of them had TB and the treatment was immediately initiated. Maihar Singh also discussed about their disease with their family members and dispelled their apprehensions. In March 2016, both of them successfully completed their treatment and are leading a happy and healthy life now.

India bears the highest TB burden in the world with an estimated 2.2 million people suffering from the disease and over 200,000 dying due to it every year. The lack of awareness, stigma and inadequate access to health facilities are some of the factors preventing patients’ from seeking timely care for this curable disease. In order to address this challenge The International Union Against TB and Lung Disease (The Union) initiated Project Axshya in nearly 300 districts in the country. Supported by The Global Fund, Axshya (meaning free from TB) is strengthening the efforts of the Revised National TB Control Programme, a flagship programme of Government of India.

The project is reaching out to vulnerable and marginalised groups who are at high risk of TB, educating them about the disease and linking them with diagnostic and treatment services available under the programme.

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One of the key interventions under the project is ‘Axshya Samvad’ in which trained community volunteers (called Axshya Mitras) go door to door creating awareness about TB and simultaneously screening people for symptoms of TB and referring them for diagnosis and treatment to the nearest public health facility. For those who are unable to go for diagnosis, the project facilitates collection of sputum from their residence which is transported to the diagnostic centre for testing, and the report is communicated to the client.

Project Axshya works innovatively with nearly 1,000 local NGOs and CBOs (community-based organisations) and nearly 15,000 Axshya Mitras. Since 2013, Axshya has reached nearly 34 million people and facilitated identification and testing of over 7, 00,000 with symptoms of TB – resulting in the diagnosis of over 58,000 TB patients who have been initiated on treatment. During this period, the Axshya Mitras collected and transported over 1,70,000 sputum samples for testing – travelling several kilometres in difficult terrain on foot, bicycle, motorbike, public transport and even boats.

The project is also working closely with Rural Healthcare Providers (RHCPs) who serve as the first point of contact for the majority of the rural population. The project trains them to identify symptoms of TB among their clients and refer them for diagnosis to the nearest public health facility. They are also trained as DOT (directly observed treatment) to supervise the treatment, which is provided free of cost by the government. Nearly 30,000 RHCPs have been trained by the project and are engaged in TB control efforts.

– Sachi Satapathy

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About the author: Sachi Satapathy is a Technical Advisor with International Union Against Tuberculosis and Lung Disease (The Union). The Union is an international organisation conducts research, provides training and offers technical assistance leading to health solutions for the poor in more than 150 countries each year.

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