Ni-kshay model can't be mainstay in eradicating TB by 2025: Parl panel
The Ni-kshay adoption model cannot be considered as the mainstay in eradicating TB by 2025, a parliamentary committee said.
In its 149th report tabled in Parliament, the Department-related Parliamentary Standing Committee on Health and Family Welfare expressed its concerns over "a sense of complacency" within the ministry and the government organisation responsible for implementing the TB elimination programme. The report said the shifting of responsibility to non-governmental organisations ''eventually may impede the overall progress'' of TB eradication. The committee suggested that the government establish a robust selection process for Ni-kshay Mitra and implement effective monitoring mechanisms to ensure their diligent fulfilment of responsibilities.
Under the Pradhan Mantri TB Mukt Bharat Abhiyan (Ni-kshay Mitra initiative) implemented by the Health Ministry, community support is provided to TB patients through the Ni-kshay 2.0 portal on which TB patients can be adopted and cared for by an individual, elected representatives or institutions.
The parliamentary committee suggested the need for organising orientation programmes for Ni-kshay Mitras to acquaint them about TB and its management. ''The close connection between nutrition and TB further reinforced the significance of this programme, as it not only strengthens the immune system of TB patients to fight against disease, it also facilitates community engagement making the TB elimination program a vital part of 24 community-driven efforts,'' the committee stated.
In order to ensure the proper utilisation of assistance extended by Ni-kshay Mitras, the committee recommended that the government introduce a monitoring mechanism to track the attitude and behaviour of the patients towards the Ni-kshay Mitras, and to provide them appropriate counselling, if required. ''The committee feels that the global resources and guidelines would lead to more effective implementation of PMTBMBA and achieving universal health coverage. Moreover, community involvement in TB control efforts, fostering awareness, understanding of TB prevention, care-seeking behaviour, and adherence to treatment are imperative steps to manage TB disease,'' the panel said.
The committee suggested that under PMTBMBA programme, political commitment at all levels of governance through regular meetings, discussions, and engagements with key stakeholders should be strengthened.
The health system's capacity and investment in research collaborations to advance the development of new diagnostics, drugs, and vaccines should also be strengthened, it said.
The panel also recommended conducting a survey on the financial impact of TB in India to get a picture of the socio-economic status and the financial burden of TB disease on a family. It said such surveys can also be combined with other health surveys on a national level so as to assess the catastrophic costs related to TB disease. The government may also explore avenues to integrate such surveys with Ni-kshay portal, the report said.
In view of the alarming rise in drug-resistant TB cases, the panel suggested that the government should make efforts to decentralise 13 healthcare delivery of DR-TB and MDR-TB services, thus providing easy access to rapid molecular diagnostics of TB upfront, including remote areas or to high-risk patients across the country.
An integrated health system approach for service delivery, including counselling in the general health system, should be implemented for early diagnosis and timely initiation of treatment, it said. The panel also suggested that a robust and exclusive surveillance system for drug-resistant TB cases should be put in place to track the patients and monitor their adherence to the prescribed treatment. India continues to be the most significant contributor to global TB incidence. Approximately one-fourth of total cases i.e. roughly 25 lakh out of 1.05 crore are reported in India. As per WHO Global TB Report 2022, eight out of 30 countries with the highest TB burden countries account for more than 2/3rd of the global TB burden and among those eight countries, India's share is 28 per cent.
In India, TB has been more commonly seen in the 15-24 and 25-34 age group in the last five years, the committee said.
With a growing tide of lifestyle-associated non-communicable diseases, poor health behaviours and unhealthy lifestyles make people more likely to have lower immunity and increased susceptibility to acquiring TB infections, the panel said. The committee said it believes the health of the young population is central to the nation's health and a robust population-based approach should be worked out to address their socio-economic conditions, healthy lifestyle and preventive strategies to have a holistic approach to the TB elimination drive.
(This story has not been edited by Devdiscourse staff and is auto-generated from a syndicated feed.)