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Ministry to submit draft for RNTCP's 2nd phase to WB
Rita Dutta - Mumbai
With the first phase of Revised National Tuberculosis Control Programme's (RNTCP)
ending in September, this year, the ministry of health and family welfare along
with experts from NGOs, TB officers and personnel from prominent TB institutes
are working to submit policy statement for the second leg of the programme to
World Bank (WB) for its funding.
Based on the proposal, to be finalised by September, WB will allocate funds
for the second five-year period, revealed an expert involved in the draft. The
first phase, supposed to have ended two years ago, has been extended till September,
this year, the expert revealed.
According to Dr Yamuna Mundade, WHO representative in the directorate of health
services, New Delhi, like the first phase, a major part of the second phase
would be funded by the World Bank. The funds would be to the tune of USD 190
million, she added.
"The policy statement for the second phase is an improvisation of the first
one, with more emphasis on improving quality and access to the programme. Importance
is accorded to make the programme more accessible to the marginalised section
of the society, a strata which the current programme is not being able to reach
out to," the expert added.
The reach of the programme had received flak from several sections of the media
in the recent past. According to a TB report card released in 2003 by four NGOs
on the World TB day, namely Massive Effort Campaign (Geneva), National Centre
for Advocacy Studies (Pune), Result International (New York) and Sahasee (Delhi),
which is an analysis of the third quarter report of DOTs in 2002, the detection
and cure rate of the programme was less than 30 per cent for more than half
of the population of the country. The analysis reported that for the states
of Andhra Pradesh, Bihar, Haryana, Karnataka, Jharkhand, Madhya Pradesh, Orissa
and Punjab, the cure and detection rate was less than 30 per cent. The study
further showed that the cure rate was above 60 per cent for Delhi, Himachel
Pradesh, Manipur and Rajasthan and it was between 30 and 60 per cent for Maharashtra,
Tamil Nadu, West Bengal, Gujarat and Kerala.
The programme would also introduce operation research (OR), which is absent
in the first phase. OR looks at an organisation's operations and uses analytical
approaches to find better ways of conducting them. "We need to constantly
improve on the programme, and for that OR is very crucial," the expert
added.
Suggestions are also mooted to make the programme more patient-friendly, right
from the TB officer to lab technician to DOTS provider. The expert cited the
example of the role of counsellors in AIDS which have had a positive impact
on the quality of care for the disease.
The expert opined that the RNTCP programme is not dogged by financial crunch
or improper policy, but lack of proper implementation.
(With inputs from Sapna Dogra, New Delhi)
— rita_dutta@rediffmail.com
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