ANSWER MDR TB

ANSWER MDR TB

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Last Update: April 30, 2012

Multi Drug Resistance TB (MDR TB) is about 12% in previously treated TB patients due to TB Program failure. Still MDR TB is a death sentence to 8% of patients. By the time patient approaches to Government health facilities, he/she would have spent lot of time and monies towards TB treatment. There is an understanding that an effective response to MDR TB requires partnership of all sectors to reduce social stigma and discrimination and to save lives. With increasing challenges of MDR TB, there is a strong need to develop new approaches, new alliances and new inputs. It is important to enhance patient’s dignity, recognizing people as subjects and not objects, and workers as enablers and not providers. Interventions must be tailor made, integrated, supportive and responsive, in totality saving many lives. Opportunities are to be explored to help them to have effective service delivery besides finding productive livelihoods and nutritional supplements. To begin with TB Alert India would like to take care of about 50 highly deserving MDR TB patients. Additional Nutritional Support and Social and Economic Rehabilitation to MDR TB (ANSWER MDR TB) Patients is a unique task will address two major requirements of MDR-TB patients are 1). Additional Nutritional Support 2). Holistic socio- economic development of family.

Type: citizen sector

The Problem

The need of initiative is to facilitate deserving 50 MDR- TB patients in getting nutrition support and linkages with Developmental (Govt./NGOs) agencies for socio economic support.MDR TB Patients have serious dual problems of access to Government services and highly insufficient nutritional supplement under high toxic medication which results in not only bankruptcy but also pushing patient on to death bed hanging at the mercy of private providers.

The Solution

In collaboration with State TB Office, profile of MDR TB Patients will be collected (who are registered during Jan–Dec 2011). Analysis of profile of study will give a base for assessing the socio economic status of MDR patient for the provision of Nutritional support for full course of treatment (24 months) and linking with the N/GO supported Welfare schemes. The nutrition support will enable patient to cope up with the basic nutrition. To be specific we build an enabling environment where all stakeholders become empathetic and offer treatment access, mobilising support bottom up for nutrition during treatment phase and building up of livelihood options to MDR TB affected families in an integrated manner. Alongside building the power of the affected for greater voice for better services, dignity , equity as fundamental right. Each identified needy MDR TB Patient empowered through the development of Patient Emancipation Committees (PECs) - regular forum to discuss any problems encountered with government health services, any suggestions to improve impact and necessary actions. More significantly sensitising, empowering and activating the passive communities around MDR TB patients to create social net and action for MDR TB control and care as role model.

Example

Our solution involves the following primary activities as a flow that would make a difference. *Profiling of MDR TB Patients *Facilitating multi stakeholder support for Treatment Access *Prioritising and providing MDR TB patient specific Nutritional requirement & Support *Mobilising MDR TB Support groups surrounding the patients and institutionalizing the services of psycho social support to patient & Family members *Promoting MDR TB patient advocates who would act as change agents if not spokespersons for MDR TB Patients and work against the stigmatisation and alienation particularly among women. *Taking up intensive watchdog role, bottom up and top down at the Government level for proper service delivery *Facilitating counseling services by the peripheral Govt. service providers at patient level to accept the long drawn treatment *Nutrition support to needy patients both by public and private systems. *Formation of Patient Emancipation Committees (PECs). PEC has 10 /15 members drawn from local & in/formal leaders, school teachers, NGOs/CBOs, Developmental line departments, Anganwadi workers, village health workers and the clients. PEC under the facilitation of project team meets once a month, reviews needs of clients and offer tailor made solutions including Vocational Training (Welding, Driving, Carpentry etc) ; Small business ventures, dairy and poultry, self-supporting ventures such as sewing machines, weaving, rickshaws, incense sticks *Special focus will be to benefit women beneficiaries in the intervention who are both affected and breadwinners.

Budget: $250,000 - $500,000

Marketplace

MDR TB is a man-made and systemic deficiency. Predominantly Revised National TB program focusing on DOTS which is inefficiently and ineffectively managed resulting into rapid increase of MDR TB cases. The greatest problem we foresee is from the service delivery system of Government which is too much bent on new case detection and fresh DOTS. There are hardly any NGOs working on MDR TB and our edge over others are our highly community oriented bottom up participatory movement(Patient support groups, Patient Advocates and socio economic support) against MDR TB. The Challenge we foresee is from two sides; one from Govt. which is not willing to accept its failure at grassroots and the society which is indifferent to accept MDR TB as a reality ejected out of patients failure earlier.

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