|For the last six years Innovators In Health has been providing care to people with Tuberculosis (TB) through a community-based program built on the scaffolding of public health system. At present, this program provides services in 2 blocksâ€”Dalsinghsarai and Vidyapati Nagarâ€”to a population of around 4 lakh. The cornerstone of our approach is active case finding through an in-field screening tool administered by ASHA. The first prong is to mobilize community to identify symptoms of TB. This generates referrals from the community itself with a list of possible people to be evaluated. The second prong is to strengthen ASHA to collect these referrals, screen them, and support them through diagnosis and treatment. These ASHA assume role of a patient enabler and advocate. The final prong is engagement with stakeholders, including public health system, panchayati raj, political representatives, to bring ownership in the process and affect policy. We have supported more than 1500 TB patients through treatment till now.
With our collaborator Bill Thies at Microsoft Research, we piloted a mobile based treatment adherence technology called 99DOTS. This has been adopted by the RNTCP amongst the range of choices offered to the patients for adherence.
Last year, we initiated a maternal and neonatal health project in Dalsinghsarai. Our approach here is similar: strengthen ASHA and ANM, and empower community. The former is aimed at ensuring early registration, complete ANC, safe delivery, and quality PNC. An equal focus in on engaging with community through mahila mandal and community counselors. Community counselor is a tribe of women who take initiatives in the community; for example, a woman who accompanies all labouring woman in her tola to the hospital. We envision them as community beacons who bring the right practices and knowledge in the community while acting as a bridge as well between the program and community. Mahila Mandal is our awareness vehicle which leverages participatory learning to promote best practices in maternal and neonatal health.
TB case detection rate in our catchment area is around 125 per lakh population, which is double of Bihar average