GROUP ACTIVITY

Comparative Study Of National Health Programs

Presented By:

Shiavng Sharma(PG/14/55)

Ashwanee Patel(PG/14/14)

National Tuberculosis

Control Program

NTF Presentations for RNTCP

Sensitization First edition 10th Nov 06

RNTCP Organization structure: National level

Health Minister

Health Secretary

MD NRHM Director Health

Services

Additional / Deputy / Joint

Director

(State TB Officer)

State TB Cell

Deputy STO, MO, Accountant,

IEC Officer, SA,

DEO, TB HIV Coordinator etc.,

State Training and Demonstration

Center (TB)

Director, IRL Microbiologist, MO,

Epidemiologist/statistician, IRL LTs etc.,

RNTCP Organization structure: State level

NTF Presentations for RNTCP

Sensitization First edition 10th Nov 06

One/ 100,000

(50,000 in hilly/ difficult/

tribal area)

One/ 500,000

(250,000 in hilly/

difficult/ tribal area)

TB Health Visitors (TBHV),

DOT Provider

(MPW, NGO, PP, ASHA,

Community Volunteers)

Medical Officer, paramedical staff

And Laboratory Technician (20-50%)

Medical officer-TB Control,

Senior Treatment supervisor(STS),

Senior TB Laboratory Supervisor(STLS)

District Health Services

District TB Centre

Tuberculosis Unit

Microscopy Centre

DOT Centre

Nodal point for TB

control

Structure of RNTCP at district levels

Chief Medical Officer and

other supporting staff

District AdministrationDistrict Magistrate/

District Collector

DTO, MO-DTC (15%), LT, DEO,

Driver, Urban TB Coordinators,

TBHVs, Communication Facilitators

Supervision, Monitoring, and

Evaluation activities under RNTCP

Levels Category of

Supervisor

Field visits (No. of

days/month)Objective Facilities to be

visited

National Officials from

Ministry of Health

and Family

Welfare, GoI.

RNTCP inclusive as a

supervisory agenda in

their routine field visits

for supervision.

Supervision of

Programme.

State TB Cell, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

National DDG (TB) and

other officials

from Central TB

Division.

10 days/month (1-2

days per visit)Supervision of

Programme.

State TB Cell, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

National Central Internal

EvaluationOne per month Evaluation of

Programme

Performance

including all aspects

such as data

validation etc…

State TB Cell, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

National National

Reference

Laboratory

All states assigned to

be visited at least once

in a year.

Supervision and

Evaluation of

External Quality

Assurance activities

State TB Cell, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

National NACO and CTD One state per

quarter

Supervision of

TB-HIV

collaborative

activities

State TB Cell, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

Levels Category of

Supervisor

Field visits (No.

of

days/month)

Objective Facilities to be

visited

State Officials from

Ministry of

Health and

Family Welfare,

State and State

Health Society.

RNTCP inclusive as

a

supervisory agenda

in

their routine field

visits

for supervision.

Supervision of

Programme.

DTC, TUs, DMCs,

PHIs, DOT Centre,

Drug Store, DOTS

Plus Site, ICTC

Centre, CCC, ART

Centre

State STO

(Including visits

by STC/STDC

officers)

12-16 days/month

(1-2 days per visit)

Supervision of

Programme

Performance.

Cover all districts

in the state every 6

month

DTC, TUs, DMCs,

PHIs, DOT Centre,

Drug Store, DOTS

Plus Site, ICTC

Centre, CCC, ART

Centre

State State Internal

Evaluation

Upto 30 million - 2

districts per quarter;

30-100 million - 3

districts per quarter;

>100 million - 3-4

districts per quarter.

Aim to cover all

districts at least once

in 3-4 years.

Evaluation of

Programme

Performance

including all aspects

such as data

validation etc…

DTC, TUs, DMCs,

PHIs, DOT Centre,

Drug Store, DOTS

Plus Site, ICTC

Centre, CCC, ART

Centre

State Intermediate

Reference

Laboratory

All districts to be

visited at least once

a

year

Supervision and

Evaluation of

External Quality

Assurance activities

DTC, TUs, DMCs,

PHIs, DOT Centre,

Drug Store, DOTS

Plus Site, ICTC

Centre, CCC, ART

Centre

Levels Category of

Supervisor

Field visits

(No. of

days/month)

Objective Facilities to be

visited

State Joint visit by

SACS and STC

officials

One district per

quarter

Supervision of

TB-HIV

collaborative

activities

District AIDS

Control office, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

District District Health

Society Members

(District

Magistrate,

RNTCP inclusive as

a

supervisory agenda

in

their routine field

visits

for supervision.

Supervision of

Programme.

District AIDS

Control office, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

District DTO (including

visits by MODTC)

20 Supervision of

Programme, Cover

all TU every month

and all DMC every

Quarter.

District AIDS

Control office, DTC,

TUs, DMCs, PHIs,

DOT Centre, Drug

Store, DOTS Plus

Site, ICTC Centre,

CCC, ART Centre

NATIONAL AIDS CONTROL

PROGRAMME

ADMINISTRATIVE STRUCTURE:

Three entities oversee NACO, they are:

National Council on AIDS

o National Council of AIDS is the most recently formed, though

hierarchically supreme.

o The Prime Minister chairs the Council and Union Health Minister serves

as Co-chairman.

o Its membership comprises of 22 Union Ministers, 7 StateChief Ministers

and selected representatives from Civil Society

National AIDS Committee

o The Union Minister of Health chairs the Committee.

o Its members include health ministers of 5 states and senior officers of

related central ministries/departments.

o The Committee also comprises of representatives from industry, trade

unions, IMA and Salvation Army as non-official members

National AIDS Control Board

The Board reviews the policies laid down by NACO, grants sanction to

various projects, undertakes procurement and awards to private

agencies.

The Board exercises all financial powers which are beyond

the powers of the Project Director, NACO and which the Department of

Health, Government of India, can exercise with the approval of the

Department of Expenditure, Ministry of Finance

COMPARISON:

ADMINISTRATIVE STRUCTURE

RNTCP NATIONAL AIDS CONTROL

PROGRAMMECENTRAL LEVEL

• Tuberculosis Division in the Directorate General

Health services

• National Tuberculosis Institute, Bangalore

• Tuberculosis Research centre at Chennai

STATE LEVEL

Health Minister

Health Secretary

MD NRHM

Director Health Services

Additional / Deputy / Joint Director

(State TB Officer)

State TB Cell

Deputy STO, MO, Accountant,

State Training and Demonstration

Center (TB)

Director, IRL Microbiologist, MO,

Epidemiologist/statistician, IRL LTs etc.,

CENTRAL LEVEL

Director General

Additional Seceratory

Dir. Admin & Project

DDG(M&E)

ADG(CST)

SO(Admin)

DirectorFinance

Accounts Officer

STATE LEVEL

State Council of HIV/AIDS(Chaired by Chief Minister)

Governing Body

Executive Committee

TSU

SACS Project director and staff

COMPARISON:

ADMINISTRATIVE STRUCTURE(CONT..)

RNTCP NATIONAL AIDS CONTROL

PROGRAMME

DISTRICT LEVEL

District Magistrate/District Collector

Chief Medical Officer and other supporting staff

DTO, MO-DTC (15%), LT, DEO, Driver, Urban TB

Coordinators, TBHVs, Communication Facilitators

Medical Officer, paramedical staff And Laboratory

Technician (20-50%)

TB Health Visitors (TBHV), DOT Provider (MPW,

NGO, PP, ASHA, Community Volunteers)

DISTRICT LEVEL

District Collector/deputy Commisioner Chairperson

CEO Zilla Parishad ,vice chairperson

Chief Medical Officer

Medical Superitendent

District Aids Control Manager

District Program Manager

District IEC Officer

Medical Officer

One representative of targeted intervention

program

Representative of relative department

COMPARISON

COMPONENTS:

RNTCP NATIONAL AIDS CONTROL

PROGRAMME

Pursue quality DOTS expansion and

enhancement

Enable and promote research

Contribute to health system strengthening

Directly observed treatmentshort-course

DOTS strategy

Intensifying and Consolidating Prevention

services with a focus on HRG and vulnerable

populations

Strengthening institutional capacities

Comprehensive Care, Support and Treatment

Expanding IEC services for general

population and high risk groups with a focus on

behavior change and demand generation