Supervision by DTO at TU level

The District TB Officer (DTO) at the District TB Centre (DTC) has the overall responsibility for the physical and financial management of the National TB Elimination Programme (NTEP) at the district level as per the guidelines.

The DTO is also responsible for the involvement of other sectors in NTEP to ensure better adherence and is assisted by a Medical Officer (MO), statistical assistant and other paramedical staff. For each district, there should be a full-time DTO, who is trained in NTEP.

The Senior Treatment Supervisor (STS) and Senior TB Lab Supervisor (STLS) at the Tuberculosis Unit (TU) level are under the administrative supervision of the DTO/ Medical Officer -TB Control (MO-TC).

The DTO conducts supervisory visits by himself/ herself, or in a team of MO-TC/ STLS/ STS. These visits are conducted on a systematic basis and the protocol to be followed during these visits is shown in the figure below.

Figure: Supervisory Protocols for the DTO

Abbr: NTEP: National TB Elimination Programme; NGO: Non-government Organisation

The following are the major points to be covered by the DTO under supervision:

• All the MO-TCs, the NTEP staff (STS, STLS, TB Health Volunteers (TBHVs), DR-TB-HIV coordinators, PPM coordinators, etc.) are conducting supervisory visits and giving proper feedback on a periodical basis.
• Early diagnosis and treatment initiation are being carried out in the district by all stakeholders.
• Private Practitioners are sensitised adequately and they are notifying all cases of TB in Nikshay.
• Treatment provided by the Public provider is as per the program guidelines and Private practitioners are as per the standards for TB care in India. 
• Public health actions are undertaken in all TB cases notified in Nikshay.
• Direct Benefit Transfer (DBT) is being provided to all beneficiaries as prescribed under NTEP.
• Nikshay recordings are updated and factual.
• External quality assurance is being carried out as per the NTEP protocol.
• Drugs and supplies are supplied uninterruptedly and as per the stocking norms at various levels.
• Microscopes and the other diagnostic equipment including the Nucleic Acid Amplification Test (NAAT) devices are adequately calibrated, and the annual maintenance is being carried out as per protocol.
• All MOs and the staff carrying out TB services in the district are adequately trained. 

Resources  

• Training Modules (1-4) for Programme Managers and Medical Officers, 2020. 
• Technical and Operational Guidelines for Tuberculosis Control, Chapter 9, RNTCP, 2019. 

Assessment