The Linking to Care Initiative aims to integrate Non-Communicable Diseases (NCDs) into the existing model of private sector engagement for TB in Chennai. The screening, diagnosis, management and prevention of TB comorbidities like Diabetes Mellitus (DM) and Hypertension (HT) results in a comprehensive, integrated, people-centred package of care services for people with TB through REACH’s Nakshatra Centers. TB Nanbans (Nanban means friend in Tamil) screen people with symptoms of TB (PwSTB), people with TB (PwTB) and their family contacts for DM and HT, give them information on NCDs and if required, link them to care services.
REACH implements this five-year project (2019-24) in Chennai with support from Advance Access & Delivery and the Lilly Global Health Partnership.
People with symptoms of TB (PwTBS), People with TB (PwTB), and contacts of PwTB who are above 30 years are screened for Diabetes and Hypertension. Free coupons for diabetes and hypertension screening are provided for HbA1c test.
A support group for people with Diabetes was launched in August 2021 to help improve the knowledge about the condition and bring about behaviour change for improved lifetyle modification and adopting healthy diet and exercise. A booklet to track key values was launched in November 2021. Read more.
Over 100 community awareness programs, both virtually and in-person, on Diabetes and Hypertension were held to educate the general public on the risk factors, signs and symptoms of NCDs, diagnosis, treatment and prevention of NCDs.
Mrs Sangeeta (name changed to protect privacy)
The project provides services for people with TB, DM and HT by ensuring screening, diagnosis, and treatment support. These services are offered by TB Nanbans based at Nakshatra Centres, our hubs for holistic care for TB and NCDs in Chennai. Most people with TB are referred by private providers to Nakshatra centres.
REACH provides lab support for Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) testing for people with TB in the private sector through three GeneXpert machines, housed at the Voluntary Health Services, Taramani. As a response to COVID-19 and to provide easy access to screening facilities for NCDs, REACH has established private-private partnerships with several laboratories in Chennai.
To ensure all PwSTB were able to access the tests for DM, private laboratories were sensitised and engaged formally to ensure free HbA1c testing through coupons. Electronic BP monitors are being used in a cohort of 20 Nakshatra Centres. TB Nanbans have been trained in the use of the equipment and recording of values on standardised formats.
Given the COVID-19 restrictions, TB Nanbans provided TB and NCD care services to people with TB or TB symptoms, as well as eligible members of the family through regular phone follow-ups.
STAMP, an acronym for Support for Treatment Adherence and Medication Protocol, is a multi-function electronic medicine dispenser and reminds users, i.e., people on treatment for TB, to take their medicine at the same time everyday, thereby assisting them to complete their treatment successfully.
REACH has developed several different communication materials targeted towards behaviour change. Download here.