Role of LSG in TB Elimination

Local Self Governance is the management of local affairs by local bodies who have been elected by the local people. There are 2 types of Local Self Government (LSG): panchayats in rural areas and municipalities in urban areas. Local self-government (LSG) has deep connections and linkages with local people.  Role of LSG in Tuberculosis (TB) elimination includes:   

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Fig 1: Role of Local Self Government in TB Elimination 

1. Awareness generation activities 

With the participation of Panchayati Raj Institution (PRI) members in rural areas and municipalities in urban areas following awareness generation activities can be carried out:

• Health education on symptoms of TB, good cough etiquettes, available services for screening, diagnosis and treatment of TB, patient support/benefit schemes, TB in vulnerable groups (children, pregnant women, diabetic patients, patients on immunosuppressants, alcoholics and smokers) with emphasis on periodic screening for TB.
• Observance of World Tuberculosis Day on March 24
• Organize health-checkup camps and talks with the TB survivors
• Sensitize Panchayat Raj Institutions (PRI) members, faith leaders etc.
• Organize anti-stigma and non-discrimination campaigns

2. Advocacy interventions

Local administration or Panchayat Raj Institutions (PRI) can be engaged in advocacy interventions to promote healthy behaviours and leverage support of TB patients:

• To install spitting bins.
• To install signages on good cough etiquettes.
• Free distribution of masks/handkerchief/tissues to TB patients in the community.

3. Services for case finding (Active and latent TB Infection)

With the help of LSGs outreach activity can be planned and undertaken by community/non-governmental organizations (NGO) volunteers, Accredited Social Health Activist (ASHA) and Multi-Purpose Worker (MPW-Male)/ Auxiliary Nurse Midwife (ANM) under the supervision of the Community Health Officer (CHO)/Medical Officer- Urban Primary Health Centre (MO-UPHC), for case finding. These activities include:

• Vulnerability assessment
• Screening for symptoms of TB using Community Based Assessment Checklist (CBAC)
• Periodic active case finding among identified vulnerable populations
• Prompt referral of persons with TB symptoms to health center

4. Treatment support and monitoring

• Local self governments can engage in formation and conducting meetings of treatment support groups.
• Health education for TB patients and their household contact personscan be conducted on TB symptoms, treatment, managing adverse drug reactions, nutrition during house visits and treatment support group meetings.
• Counselling for TB patients and caregivers can be organised by PRI members and local administration.
• LSGs can mobilise funds from philanthropists to support the TB Patients, to supplement and augment healthcare facilities, screening and testing requirements, buying diagnostics and any other resources that might be required.

5. TB preventive measures

• Under supervision of LSGs screening can be conducted of household/workplace contact persons and other contact persons of TB patients as eligible in the local context and identified vulnerable population for TB/latent TB infection.
• LSG can promote airborne infection control at workplaces and community settings.

6. Interventions to ensure community participation

• LSGs can participate in identifying and training TB Champions and facilitate their participation in Village Health Sanitation Nutrition Committees (VHSNCs), Mahila Arogya Samitis (MASs), Jan Arogya Samitis and TB forum meetings.
• VHSNCs and MASs can discuss TB related issues in their meetings, conduct awareness programmes and extend support to case finding and treatment.

Resources 

• Operational Guidelines for TB Services at Ayushman Bharat Health and Wellness Centres Central TB Division, Ministry of Health and Family Welfare (MoHFW), Government of India 2020  
• Pradhan Mantri Khanij Kshetra Kalyan Yojana (PMKKKY), Ministry of Mines, Government of India, 2015. 
• Training Modules (5-9) for Programme Managers and Medical Officers, Central TB Division, Ministry of Health and Family Welfare (MoHFW), Government of India, 2020. 

Assessment