Project Axshya (meaning 'free of TB') accelerated access to quality TB services available through the NTEP for the vulnerable and marginalised (or ‘at risk’) populations. REACH implemented the project in Tamil Nadu between 2010 and 2021, as a sub-recipient of the International Union against Tuberculosis and Lung Disease. The fourth phase of Project Axshya was implemented in five districts of Tamil Nadu − Cuddalore, Krishnagiri, Madurai, Thanjavur and Trichy till March 2021.
Read more about the project here.
More than 55 lakh people were sensitised on Tuberculosis and TB care services available through the TB programme through one-to-one sensitisation meetings called Axshya SAMVAD and community meetings.
Overall, 1.5 lakh people with symptoms of TB identified and referred for testing to NTEP facilities. One lakh people tested and 7000 diagnosed with TB.
9773 TB people with TB including 3263 women sensitised on their rights and responsibilities through Patient Charter meetings.
14 District TB Forums were formed to support people with TB through community participation. Members of these TB forums come from a cross-section of society, including active members from the community and civil society, TB survivors and NGOs. During COVID-19, TB forum members stepped up to support TB-affected communities, including providing livelihood and nutrition support to people with TB and TB survivors and personal protective equipment to TB centres.
A cadre of 100 Community Volunteers were trained and engaged to provide quality TB care services. They conducted various activities along with the district team for raising awareness in the community on TB through one-to-one meetings, were part of active TB surveillance units, and were on the frontlines during the first wave of COVID-19 following up with people with symptoms for testing and diagnosis. They also supported the NTEP in case finding activities.
Congregate settings such as industries, shelter homes, mines, construction sites, prisons etc. were identified and health camps conducted to identify people with TB symptoms. To address the stigma associated with TB, a general health camp was organised and treatment of people with symptoms other than TB was also facilitated.
R Kaladevi, Community Volunteer with Project Axshya
This enhanced community-based case finding activity was carried out through Community Volunteers doing house-to-house sensitisation on TB, its symptoms, testing and treatment facilities under the TB programme. It focussed on intensifying outreach in vulnerable areas.
Community volunteers identified from the local population in select villages were trained to carry out TB surveillance activities. The volunteers helped establish a system and ensured the continuum of services in identifying and linking people with TB to TB care services.
People with TB symptoms attending district hospitals as Outpatients (OP) were fasttracked, thus addressing the high load of OPs in these facilities. The volunteer placed at the district hospital identified people with TB symptoms at the OP registration counter, sensitised them on TB and accompanied them directly to the lab for testing.
Community meetings were held to address key populations like the village health committee, members of self-help groups (SHGs), youth groups and vulnerable and marginalised villages. Engaging means of sensitisation including street theatre, wall paintings and other mass communication campaigns were used. This activity was concluded in 2017.
People with TB symptoms identified through various activities were referred and encouraged to directly go to the Designated Microscopy Centres for testing. Alternatively, Community Volunteers supported them in diagnosis by collecting and transporting the sputum sample and accompanying the person with symptoms to the lab. People who tested sputum negative were further referred for X-rays.
Axshya Kiosk: For person-centred care, these kiosks provide TB information, counselling and directly observed treatment services to patients and their families for their convenience in government and private hospitals and within spaces in the affected community
Other interventions include sensitisation programmes for prison inmates, sensitising Rural (alternate) Healthcare Providers which helped in facilitation of diagnosis and treatment of people with TB and sensitisation of private practitioners, hospitals and labs on the Standards of TB Care in India guidelines and TB case notification facilitated.